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NPI Code Detail

MEDICARE: MARY PAT GRETEMAN ARNP, NNP-BC

MEDICARE: MARY PAT GRETEMAN ARNP, NNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LN0005XCritical Care Neonatal Nurse PractitionerK076749IA
2363LP0200XPediatric Nurse PractitionerK076749IA

General Provider Information

NPI Number : 1053547471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY PAT GRETEMAN ARNP, NNP-BC
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 888-573-5437
Fax Number :
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 888-573-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2009
Last Update Date : 03/17/2018

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