Healthcare Provider Details

I. General information

NPI: 1043953292
Provider Name (Legal Business Name): MEGAN N YANK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MERCY DR
COUNCIL BLUFFS IA
51503-3128
US

IV. Provider business mailing address

800 MERCY DR
COUNCIL BLUFFS IA
51503-3128
US

V. Phone/Fax

Practice location:
  • Phone: 712-328-5230
  • Fax:
Mailing address:
  • Phone: 712-328-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57121
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number83774-20
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37429
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: