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General NPI Number Information
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NPI Number | 1194704791
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Entity Type | Individual
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Provider Name | MICHELE ANN GANSHIRT A.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 1690 ELM ST STE 300
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City | DUBUQUE
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State | IA
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Zip | 52001-3679
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Country | US
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Telephone | 563-690-2850
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Fax | 563-557-8488
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Provider Business Mailing Address
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Address Line | 1500 DELHI ST STE 3500
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City | DUBUQUE
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State | IA
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Zip | 52001-6321
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Country | US
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Telephone | 563-557-3900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | C074700
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License Number State | IA
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