MEDICARE: DENISE M DEFALCO-MCGEEIN APN

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
1	363LW0102X	Women's Health Nurse Practitioner	209-003068	IL
2	363LW0102X	Women's Health Nurse Practitioner	F-103719	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184629107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE M DEFALCO-MCGEEIN APN

Provider Business Mailing Address
First Line	:	4480 UTICA RIDGE RD
Second Line	:	STE 1140
City	:	BETTENDORF
State	:	IA
Zip	:	52722-1656
Country	:	US
Telephone Number	:	563-742-5700
Fax Number	:	563-742-5705

Provider Business Practice Location Address
First Line	:	4480 UTICA RIDGE RD
Second Line	:	STE 1140
City	:	BETTENDORF
State	:	IA
Zip	:	52722-1656
Country	:	US
Telephone Number	:	563-742-5700
Fax Number	:	563-742-5705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/21/2012

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