Healthcare Provider Details

I. General information

NPI: 1942586755
Provider Name (Legal Business Name): ANDREW D WHITTERS ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E JEFFERSON ST SUITE 301
IOWA CITY IA
52245-2477
US

IV. Provider business mailing address

PO BOX 2027
IOWA CITY IA
52244-2027
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-3604
  • Fax: 319-887-2879
Mailing address:
  • Phone: 319-339-3541
  • Fax: 319-358-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA111437
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-111437
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: