Provider Demographics
NPI:1538754197
Name:STENZEL, MADELEINE
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:STENZEL
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 1:1301 PENN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2364
Mailing Address - Country:US
Mailing Address - Phone:515-263-2400
Mailing Address - Fax:
Practice Address - Street 1:1301 PENN AVE STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2364
Practice Address - Country:US
Practice Address - Phone:515-263-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15177363A00000X
IA115822363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant