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General NPI Number Information
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NPI Number | 1245298934
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Entity Type | Organization
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Legal Business Name | WOMEN'S WELLNESS CENTER, PC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 777 MAZZUCHELLI PL
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City | DUBUQUE
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State | IA
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Zip | 52001-7359
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Country | US
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Telephone | 563-588-0011
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Fax | 563-588-0595
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Provider Business Mailing Address
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Address Line | PO BOX 2400
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City | WATERLOO
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State | IA
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Zip | 50704-2400
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Country | US
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Telephone | 319-233-3044
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Fax | 319-233-0722
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTAN
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Name | KELLY S MCMAHON
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Credential |
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Telephone | 319-233-3044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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