Healthcare Provider Details

I. General information

NPI: 1437815016
Provider Name (Legal Business Name): ANTOINETTE KATHLEEN MARTZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 12/15/2024
Certification Date: 12/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 634
DAYTON IA
50530-0634
US

IV. Provider business mailing address

2350 HOSPITAL DR
WEBSTER CITY IA
50595-6600
US

V. Phone/Fax

Practice location:
  • Phone: 515-570-8569
  • Fax:
Mailing address:
  • Phone: 515-570-8569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA166068
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: