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NPI Code Detail

MEDICARE: JENNIFER STIFFLER

MEDICARE: JENNIFER STIFFLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1962358689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER STIFFLER
Provider Business Mailing Address
First Line : 3601 16TH AVE SW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52404-2328
Country : US
Telephone Number : 319-390-4611
Fax Number :
Provider Business Practice Location Address
First Line : 3601 16TH AVE SW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52404-2328
Country : US
Telephone Number : 319-390-4381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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