| NPI | 1922002591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J JERGENSON President 563-242-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 22254) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A-080599) |
| 363A00000X Physician Assistant (Licence: IA 00961) | |
| 363L00000X Nurse Practitioner (Licence: IA A-077904) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2008-10-28 |