Most Relevant Information
Provider Data
| NPI Number: | 1003224585 |
| Provider Name: | STEPHANIE WITHEROW FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 115535 |
Most Important Dates
| Enumeration Date: | 07/28/2014 |
| Last Updated: | 02/06/2018 |
Provider Practice Location
500 W RIVER DR
DAVENPORT
IA
528011014
Practice Location Phone/Fax
| Phone: | 5633363000 |
| Fax: | 5633363125 |
Provider Mailing Location
500 W RIVER DR
DAVENPORT
IA
528011014
Provider Mailing Phone/Fax
| Phone: | 5633363000 |
| Fax: | 5633363125 |