Healthcare Provider Details

I. General information

NPI: 1710094354
Provider Name (Legal Business Name): CAROL LINDA CALDWELL RN, ARNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NEWTON ROAD 101 NURSING BUILDING
IOWA CITY IA
52242-1121
US

IV. Provider business mailing address

2213 GRAND AVE
DES MOINES IA
50312-5305
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-9654
  • Fax: 319-335-7106
Mailing address:
  • Phone: 515-237-3974
  • Fax: 515-883-2692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number078364
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberT078369
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: