Shannon Ranae Stafford
Nurse Practitioner - Women's Health
1604 2nd Ave
Council Bluffs
, Iowa 51501-3801
Shannon Ranae Stafford
Nurse Practitioner - Women's Health
1604 2nd Ave
Council Bluffs
, Iowa 51501-3801
(712) 325-9977
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Shannon Ranae Stafford
- 2512 Thallas St
- Council Bluffs, IA
- Zip : 51503-8600
- Phone : (712) 325-9977
Second Address
- Shannon Ranae Stafford
- 1604 2nd Ave
- Council Bluffs, IA
- Zip : 51501-3801
- Fax : (712) 328-7985
- Phone : (712) 322-6650
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | F-091658 | IA |
National Provider Identifier
| NPI | 1063542884 |
|---|---|
| Provider Name | Shannon Ranae Stafford |
| First Address | Council Bluffs, IA 51503-8600 |
| Second Address | Council Bluffs, IA 51501-3801 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0131656 | (05) | IA |
| P80438 | (02) | IA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.