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NPI Code Detail

MEDICARE: JADE L RUNGE ARNP

MEDICARE: JADE L RUNGE ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LN0005XCritical Care Neonatal Nurse PractitionerK112925IA
2363LN0000XNeonatal Nurse PractitionerK112925IA

General Provider Information

NPI Number : 1174880744
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE L RUNGE ARNP
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-8931
Fax Number :
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-8931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 05/07/2019

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