Healthcare Provider Details
I. General information
NPI: 1548810625
Provider Name (Legal Business Name): MRS. MORGAN ELIZABETH SPIELMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/19/2019
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
116 E 11TH ST STE 101
SPENCER IA
51301-4365
US
IV. Provider business mailing address
4527 HAWTHORNE DRIVE
SIOUX CITY IA
51106
US
V. Phone/Fax
- Phone: 712-264-3500
- Fax:
- Phone: 515-571-4025
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A156290 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 137373 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: