Healthcare Provider Details

I. General information

NPI: 1548105885
Provider Name (Legal Business Name): JOHN MICHAEL RUEHS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CYCLONE DR
WATERLOO IA
50701-9715
US

IV. Provider business mailing address

2515 CYCLONE DR
WATERLOO IA
50701-9715
US

V. Phone/Fax

Practice location:
  • Phone: 319-888-8044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA190338
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: