Healthcare Provider Details

I. General information

NPI: 1750004891
Provider Name (Legal Business Name): INTEGRATED HEALTHCARE OF IOWA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 OAK ST
BURLINGTON IA
52601-4608
US

IV. Provider business mailing address

903 OAK ST
BURLINGTON IA
52601-4608
US

V. Phone/Fax

Practice location:
  • Phone: 319-209-2150
  • Fax: 319-209-2149
Mailing address:
  • Phone: 319-209-2150
  • Fax: 319-209-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE SUE PRISNER
Title or Position: OWNER/AUTHORIZED INDIVIDUAL
Credential: DNP FNP-BC PMHNP-BC
Phone: 319-209-2150