Healthcare Provider Details

I. General information

NPI: 1639826316
Provider Name (Legal Business Name): CASSANDRA LEANN DUNIVAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA L. BROWN ARNP

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 01/21/2023
Certification Date: 01/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 GEAR AVE
WEST BURLINGTON IA
52655
US

IV. Provider business mailing address

10 HARMONY CT
FORT MADISON IA
52627-2216
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4320
  • Fax:
Mailing address:
  • Phone: 641-217-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF02220824
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: