| NPI | 1083193528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE JANAE KATZ Billing Manager 515-233-3971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 35329) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001300) |
| 363L00000X Nurse Practitioner (Licence: IA A127170) | |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |