Healthcare Provider Details

I. General information

NPI: 1437552304
Provider Name (Legal Business Name): ANITA SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 10TH ST SE STE 150
CEDAR RAPIDS IA
52403-2449
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-3600
  • Fax: 319-363-9971
Mailing address:
  • Phone: 319-467-2000
  • Fax: 319-467-2815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number075174
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number075174
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: