Susan Jane Handke, ARNP

Individual provider Active NPI Nurse Practitioner · Sergeant Bluff, IA

NPI 1366442337 · NPPES record last updated Aug 10, 2015

Key facts

NPI
1366442337
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
A068082 (IA)
Practice address
319 Sergeant Square Dr
Sergeant Bluff, IA 51054-7729
Phone
(712) 943-2500
Fax
(712) 943-5696
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051027001120 IA Practitioner - Nurse Practitioner 1153348248 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A068082IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Current
since Sep 7, 2015
Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

319 Sergeant Square Dr
Sergeant Bluff, IA 51054
Phone (712) 943-2500

2730 Pierce St
Ste 205
Sioux City, IA 51104
Phone (712) 279-3383

5885 Sunnybrook Dr
Ste E100
Sioux City, IA 51106
Phone (712) 266-2700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A068082 IA Yes

Addresses

Primary practice location

319 Sergeant Square Dr
Sergeant Bluff, IA 51054-7729

Mailing address

319 Sergeant Square Dr
Sergeant Bluff, IA 51054-7729
Phone (712) 943-2500

Other identifiers

IdentifierTypeStateIssuer
0482851MedicaidIA
19920OtherWELLMARK BCBS OF IOWA
P00353507OtherMEDICARE RAILROAD
6830700MedicaidSD

Other providers in Sergeant Bluff, IA

All providers in Sergeant Bluff, IA · Nurse Practitioner in Iowa

Sources for this page

Verify at the official NPI Registry.