Healthcare Provider Details

I. General information

NPI: 1457409948
Provider Name (Legal Business Name): MARIA D PRINGLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA DIANE VANDYKE

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2647 UNION DRIVE ISU THIELEN STUDENT HEALTH CENTER
AMES IA
50011
US

IV. Provider business mailing address

PO BOX 3014 1215 DUFF AVE MCFARLAND CLINIC PC
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-294-5801
  • Fax: 515-294-5457
Mailing address:
  • Phone: 515-239-4400
  • Fax: 515-239-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA079559
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: