Individual provider Active NPI

Elizabeth Lorene Hinzmann, ARNP

  • Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1770906109
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A121973 Issued in IA
Practice address
3502 Metro Drive
Suite 200
Council Bluffs, IA 51501
Phone
(712) 256-7172
Fax
(712) 256-7374
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A121973 IA Primary

Addresses

Primary practice location

3502 Metro Drive
Suite 200
Council Bluffs, IA 51501

Mailing address

1288 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (712) 328-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A121973IAMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1770906109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 VALLEY VIEW DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035245",
            "telephone_number": "712-328-8800",
            "fax_number": "712-328-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 METRO DRIVE",
            "address_2": "SUITE 200",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51501",
            "telephone_number": "712-256-7172",
            "fax_number": "712-256-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINZMANN",
        "first_name": "ELIZABETH",
        "middle_name": "LORENE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A121973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.