Healthcare Provider Details

I. General information

NPI: 1396824918
Provider Name (Legal Business Name): NANCY MARIE RAHE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 LIONS DR
NORTH LIBERTY IA
52317-9575
US

IV. Provider business mailing address

2346 MORMON TREK BLVD STE 1500
IOWA CITY IA
52246-4371
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-5050
  • Fax: 319-467-7130
Mailing address:
  • Phone: 319-337-7642
  • Fax: 319-339-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA108489
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: