Healthcare Provider Details

I. General information

NPI: 1003073867
Provider Name (Legal Business Name): LAURA NAMETH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W 7TH ST
DUBUQUE IA
52001-2375
US

IV. Provider business mailing address

220 W 7TH ST
DUBUQUE IA
52001-2375
US

V. Phone/Fax

Practice location:
  • Phone: 563-583-6431
  • Fax: 563-557-4447
Mailing address:
  • Phone: 563-583-6431
  • Fax: 563-557-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number085911
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: