Healthcare Provider Details

I. General information

NPI: 1780532580
Provider Name (Legal Business Name): SIOUXLAND COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 PIERCE ST
SIOUX CITY IA
51105-1452
US

IV. Provider business mailing address

1021 NEBRASKA ST
SIOUX CITY IA
51105-1436
US

V. Phone/Fax

Practice location:
  • Phone: 712-252-2477
  • Fax: 712-252-5920
Mailing address:
  • Phone: 712-252-2477
  • Fax: 712-252-5920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CLARA TALIA PETERSON
Title or Position: CFO
Credential:
Phone: 712-252-2477