Individual provider · NPI-1

Stacy Michelle Lister, ARNP- FNP-C

Nurse Practitioner, Family · Grimes, IA

NPI number1649047143
StatusActive
Last updated in NPPESDec 5, 2023

Details

NPI
1649047143
Entity type
Individual (NPI-1)
Name
Miss Stacy Michelle Lister
Credential
ARNP- FNP-C
Sex
Female
Sole proprietor
No
Enumeration date
Dec 5, 2023
Certification date
Dec 5, 2023
Last updated
Dec 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyA176205IAYes

Practice location

101 Se Destination Dr
Grimes, IA 50111-6608

Phone 515-986-4524 · Fax 515-986-4531

Mailing address

101 Se Destination Dr
Grimes, IA 50111-6608

Phone 515-986-4524 · Fax 515-986-4531

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