Associates in Dermatology
Organization Active NPI Nurse Practitioner · Ottumwa, IA
NPI 1104018472 · NPPES record last updated Aug 10, 2007
Key facts
- NPI
- 1104018472
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- ASSOCIATES IN DERMATOLOGY
- Practice address
- 1005 Pennsylvania Ave
Ottumwa, IA 52501-6413 - Phone
- (641) 683-3195
- NPI assigned
- Aug 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Richard T Ameln
- Title
- Physician
- Phone
- (641) 683-3195
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
1005 Pennsylvania Ave
Ottumwa, IA 52501-6413
Mailing address
1005 Pennsylvania Ave
Ottumwa, IA 52501-6413
Phone (641) 683-3195
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0420471 | Medicaid | IA |
Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.