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General NPI Number Information
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NPI Number | 1770393522
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Entity Type | Organization
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Legal Business Name | MAIN STREET FAMILY WELLNESS
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 300 MAIN ST
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City | AMES
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State | IA
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Zip | 50010-6189
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Country | US
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Telephone | 515-393-1898
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Fax | 515-329-9174
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Provider Business Mailing Address
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Address Line | 300 MAIN ST
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City | AMES
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State | IA
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Zip | 50010-6189
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Country | US
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Telephone | 515-393-1898
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Fax | 515-329-9174
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Authorized Official
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Title or Position | OWNER, ARNP
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Name | BRITTNI REIFSCHNEIDER
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Credential | ARNP
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Telephone | 515-393-1898
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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