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General NPI Number Information
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NPI Number | 1720759822
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Entity Type | Individual
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Provider Name | SEAIRA MARIE DRISH FNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 304 FRANKLIN ST
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City | KEOSAUQUA
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State | IA
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Zip | 52565-1164
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Country | US
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Telephone | 319-293-3171
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Fax |
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Provider Business Mailing Address
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Address Line | 15785 250TH ST
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City | MILTON
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State | IA
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Zip | 52570-8122
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Country | US
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Telephone | 319-461-7047
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | A165854
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A165854
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License Number State | IA
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