Healthcare Provider Details
I. General information
NPI: 1245192616
Provider Name (Legal Business Name): BRENT CHRISTOPHER STRABALA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 HIGHWAY 6 W
IOWA CITY IA
52246-2209
US
IV. Provider business mailing address
530 N OLIPHANT ST
WEST BRANCH IA
52358-9701
US
V. Phone/Fax
- Phone: 319-338-0581
- Fax:
- Phone: 319-338-0581
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WE0900X |
| Taxonomy | Enterostomal Therapy Registered Nurse |
| License Number | 102480 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX1500X |
| Taxonomy | Ostomy Care Registered Nurse |
| License Number | 102480 |
| License Number State | IA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | 102480 |
| License Number State | IA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | 102480 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: