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General NPI Number Information
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NPI Number | 1720880164
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Entity Type | Individual
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Provider Name | SHANA MICHELE STAAB RN
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1075 1ST AVE SE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-5003
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Country | US
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Telephone | 319-558-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 RIDGE TOP DR NE
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City | SWISHER
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State | IA
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Zip | 52338-9421
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Country | US
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Telephone | 319-533-7135
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Fax |
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 089438
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 163WI0600X
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Taxonomy Name | Infection Control Registered Nurse
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License Number | 089438
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License Number State | IA
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