Provider Demographics
NPI:1235388190
Name:HUCKFELT, STACIE K
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:K
Last Name:HUCKFELT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-0017
Mailing Address - Country:US
Mailing Address - Phone:712-262-7774
Mailing Address - Fax:712-262-6758
Practice Address - Street 1:119 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5012
Practice Address - Country:US
Practice Address - Phone:712-262-7774
Practice Address - Fax:712-262-6758
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA928237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist