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NPI Code Detail

MEDICARE: HEIDI M WAUTERS ARNP

MEDICARE: HEIDI M WAUTERS 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
1363LF0000XFamily Nurse Practitioner104766IA

General Provider Information

NPI Number : 1891806790
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI M WAUTERS ARNP
Provider Business Mailing Address
First Line : 255 W LUCAS ST
Second Line :
City : MARENGO
State : IA
Zip : 52301-1331
Country : US
Telephone Number : 319-741-6798
Fax Number : 319-741-6791
Provider Business Practice Location Address
First Line : 255 W LUCAS ST
Second Line :
City : MARENGO
State : IA
Zip : 52301-1331
Country : US
Telephone Number : 319-741-6798
Fax Number : 319-741-6791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ HEIDI M WAUTERS ARNP” Practice Location

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