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General NPI Number Information
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NPI Number | 1588789861
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Entity Type | Organization
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Legal Business Name | BLADDER CONTROL SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 210 N HAMPSHIRE AVE
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City | MASON CITY
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State | IA
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Zip | 50401-3523
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Country | US
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Telephone | 641-423-2352
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Fax |
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Provider Business Mailing Address
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Address Line | 210 N HAMPSHIRE AVE
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City | MASON CITY
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State | IA
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Zip | 50401-3523
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Country | US
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Telephone | 641-423-2352
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. JOANN MARIE ERMER-SELTUN
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Credential | ARNP
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Telephone | 641-512-0902
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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 | A072091
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License Number State | IA
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