Healthcare Provider Details

I. General information

NPI: 1578535639
Provider Name (Legal Business Name): BRENDA S OBERHELMAN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 KENYON RD
FORT DODGE IA
50501-5776
US

IV. Provider business mailing address

24 N 9TH ST
FORT DODGE IA
50501-3905
US

V. Phone/Fax

Practice location:
  • Phone: 515-574-6800
  • Fax: 515-574-6816
Mailing address:
  • Phone: 515-574-6890
  • Fax: 515-574-6112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA068306
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: