MEDICARE: MRS. MIKA LEANN WESTFALL ARNP

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	363LF0000X	Family Nurse Practitioner	A179929	IA

General Provider Information

NPI Number	:	1417792003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIKA LEANN WESTFALL ARNP

Provider Business Mailing Address
First Line	:	202 10TH ST SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52403-2414
Country	:	US
Telephone Number	:	319-297-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 10TH ST SE STE 165
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52403-2433
Country	:	US
Telephone Number	:	319-297-2900
Fax Number	:

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

Provider Enumeration Date	:	06/26/2024
Last Update Date	:	06/26/2024

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