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General NPI Number Information
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NPI Number | 1700302825
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Entity Type | Individual
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Provider Name | PAULETTE M GLEASON ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 1303 11TH AVE
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City | MANSON
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State | IA
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Zip | 50563-5065
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Country | US
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Telephone | 712-469-3307
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1455
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City | DES MOINES
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State | IA
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Zip | 50306-1455
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Country | US
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Telephone | 515-471-9300
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Fax | 515-471-9320
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A091958
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License Number State | IA
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