Provider Demographics
NPI:1760032569
Name:MUNIER, STEPHANIE N (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:N
Last Name:MUNIER
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:NADINE
Other - Last Name:DELAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGPCNP-BC
Mailing Address - Street 1:2451 WOOD LILY RDG
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-8449
Mailing Address - Country:US
Mailing Address - Phone:319-415-6498
Mailing Address - Fax:
Practice Address - Street 1:1616 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3453
Practice Address - Country:US
Practice Address - Phone:563-263-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH156066363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner