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General NPI Number Information
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NPI Number | 1629331848
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Entity Type | Individual
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Provider Name | MEGAN L STUKENHOLTZ ARNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 2815 100TH ST # 113
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City | URBANDALE
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State | IA
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Zip | 50322-3860
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Country | US
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Telephone | 515-344-7755
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Fax | 515-809-3855
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Provider Business Mailing Address
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Address Line | 16174 150TH ST
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City | PERRY
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State | IA
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Zip | 50220-6211
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Country | US
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Telephone | 515-344-7755
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Fax | 515-809-3855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 118802
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 118802
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License Number State | IA
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