Healthcare Provider Details

I. General information

NPI: 1528874344
Provider Name (Legal Business Name): EMILY D PUETZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY PEDERSON

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 A AVE NE STE 300
CEDAR RAPIDS IA
52402-5064
US

IV. Provider business mailing address

855 A AVE NE STE 300
CEDAR RAPIDS IA
52402-5064
US

V. Phone/Fax

Practice location:
  • Phone: 319-368-9300
  • Fax:
Mailing address:
  • Phone: 319-368-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberC181902
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: