Healthcare Provider Details

I. General information

NPI: 1275408270
Provider Name (Legal Business Name): EMILY ANN WUBBEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N 15TH ST
FORT DODGE IA
50501-4129
US

IV. Provider business mailing address

210 N 15TH ST
FORT DODGE IA
50501-4129
US

V. Phone/Fax

Practice location:
  • Phone: 515-574-6810
  • Fax:
Mailing address:
  • Phone: 515-574-6810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF08250211
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: