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Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1083169270

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
320 W WALNUT ST  OGDEN, IA 50212-3060 US
Tel: 515-275-2417  Fax: 515-275-4678

Contact information for business:
603 W STATE ST  JEFFERSON, IA 50129-1723 US
Tel: 515-370-4935  Fax: 515-386-4935

Registration Information:
NPI: 1083169270
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Legacy codes, insurance codes and state license numbers:



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