Healthcare Provider Details

I. General information

NPI: 1104795475
Provider Name (Legal Business Name): KAITLIN SARAH CARD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 ESSIE DAVISON DR
CLARINDA IA
51632-2915
US

IV. Provider business mailing address

708 N 15TH ST
CLARINDA IA
51632-1121
US

V. Phone/Fax

Practice location:
  • Phone: 712-542-2176
  • Fax:
Mailing address:
  • Phone: 712-370-5116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9999999125161
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: