Healthcare Provider Details

I. General information

NPI: 1225743875
Provider Name (Legal Business Name): MATTHEW THOMAS WESSLING ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S CLARK ST
CARROLL IA
51401-3065
US

IV. Provider business mailing address

405 S CLARK ST
CARROLL IA
51401-3065
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-2222
  • Fax:
Mailing address:
  • Phone: 712-792-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA172506
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: