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General NPI Number Information
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NPI Number | 1952304222
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Entity Type | Organization
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Legal Business Name | CENTRAL IOWA HEALTHCARE
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 04/05/2017
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Provider Practice Location Address
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Address Line | 3 S 4TH AVE
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-2998
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Country | US
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Telephone | 641-754-5151
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Fax | 641-844-6208
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Provider Business Mailing Address
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Address Line | 3 S 4TH AVE
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-2998
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Country | US
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Telephone | 641-754-5145
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Fax | 641-844-6208
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Authorized Official
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Title or Position | ACTING CEO
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Name | MS. DAWNETT L. WILLIS
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Credential |
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Telephone | 641-754-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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