Healthcare Provider Details

I. General information

NPI: 1962366492
Provider Name (Legal Business Name): LISA JUNE IRWIN MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 W
IOWA CITY IA
52246-2209
US

IV. Provider business mailing address

119 NYENHUIS ST
MUSCATINE IA
52761-2056
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax: 319-339-7132
Mailing address:
  • Phone: 319-338-0581
  • Fax: 319-339-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number112307
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: