Healthcare Provider Details

I. General information

NPI: 1285666883
Provider Name (Legal Business Name): CHERYL A NIEWOEHNER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 10/12/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 N MAPLE AVE
NEW HAMPTON IA
50659-1142
US

IV. Provider business mailing address

PO BOX 1894
MASON CITY IA
50402-1894
US

V. Phone/Fax

Practice location:
  • Phone: 641-394-2151
  • Fax: 641-394-1999
Mailing address:
  • Phone: 641-494-3900
  • Fax: 641-494-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA058278
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: