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General NPI Number Information
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NPI Number | 1326541871
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Entity Type | Organization
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Legal Business Name | HALO HEALTH & PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 350 N GRANDVIEW AVE
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City | DUBUQUE
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State | IA
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Zip | 52001-6388
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Country | US
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Telephone | 563-557-2894
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 758
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City | DUBUQUE
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State | IA
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Zip | 52004-0758
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Country | US
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Telephone | 563-542-8783
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGEL KELLER
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Credential | NP
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Telephone | 563-542-8782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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