Healthcare Provider Details

I. General information

NPI: 1679619795
Provider Name (Legal Business Name): MICHELE ANN BJORN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 ESSIE DAVISON DR
CLARINDA IA
51632-2915
US

IV. Provider business mailing address

PO BOX 217
CLARINDA IA
51632-2625
US

V. Phone/Fax

Practice location:
  • Phone: 712-542-8330
  • Fax: 712-542-3373
Mailing address:
  • Phone: 712-542-2176
  • Fax: 712-542-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA092312
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: