Healthcare Provider Details

I. General information

NPI: 1154189256
Provider Name (Legal Business Name): LINDSAY RAVE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W MAIN ST
MANCHESTER IA
52057-1526
US

IV. Provider business mailing address

712 W MAIN ST
MANCHESTER IA
52057-1525
US

V. Phone/Fax

Practice location:
  • Phone: 319-833-5381
  • Fax: 319-833-5386
Mailing address:
  • Phone: 563-822-1435
  • Fax: 563-822-1436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA178566
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: