Provider Demographics
NPI:1174862148
Name:STOLL, HALEY DIANNE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:DIANNE
Last Name:STOLL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:HALEY
Other - Middle Name:DIANNE
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:1129 MORMON TREK BLVD
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4409
Mailing Address - Country:US
Mailing Address - Phone:712-281-9230
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375924081363LP0200X
MO2013002947363LP0200X
IAC121514363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics