=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083788996
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MCDONALD POLLOCK HEALTH CLINIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 TOWNCREST LN
-----------------------------------------------------
City | IOWA CITY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52240-6630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-338-3900
-----------------------------------------------------
Fax | 319-338-3907
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 TOWNCREST LN
-----------------------------------------------------
City | IOWA CITY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52240-6630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-338-3900
-----------------------------------------------------
Fax | 319-338-3907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER, FAMILY NURSE PRACTITIONER
-----------------------------------------------------
Name | MS. ANNE ELIZABETH POLLOCK
-----------------------------------------------------
Credential | ARNP, MSN, FNP
-----------------------------------------------------
Telephone | 319-338-3900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A102923
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | F077233
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------