MEDICARE: MS. NANCY D TRIMBLE PA

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	363A00000X	Physician Assistant	1401	NE
2	363A00000X	Physician Assistant	001539	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	099588004	OTHER	NE	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	23078	OTHER	NE	BCBS

General Provider Information

NPI Number	:	1457352049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY D TRIMBLE PA

Provider Business Mailing Address
First Line	:	200 HAWKINS DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:	319-384-9010
Fax Number	:	319-335-8318

Provider Business Practice Location Address
First Line	:	2591 HOLIDAY RD
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52241-3039
Country	:	US
Telephone Number	:	319-467-7150
Fax Number	:	319-335-8318

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	12/03/2020

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Directions to “ MS. NANCY D TRIMBLE PA” Practice Location

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