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NPI Code Detail

MEDICARE: HEATHER HERMANSON LISW

MEDICARE:   HEATHER  HERMANSON  LISW
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
11041C0700XClinical Social Worker096036IA

General Provider Information

NPI Number : 1487214003
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER HERMANSON LISW
Provider Business Mailing Address
First Line : 1220 NE STATION XING STE 210
Second Line :
City : GRIMES
State : IA
Zip : 50111-8013
Country : US
Telephone Number : 515-505-3321
Fax Number :
Provider Business Practice Location Address
First Line : 1220 NE STATION XING
Second Line :
City : GRIMES
State : IA
Zip : 50111-8013
Country : US
Telephone Number : 515-505-3321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 02/15/2023

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Directions to “ HEATHER HERMANSON LISW” Practice Location

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