Lisa A Bartruff, ARNP

Individual provider Active NPI Nurse Practitioner · Iowa City, IA

NPI 1790909604 · NPPES record last updated Nov 21, 2007

Key facts

NPI
1790909604
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
K068214 (IA)
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2296
Fax
(319) 356-4855
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
K068214IAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X K068214 IA Yes

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2296

Other identifiers

IdentifierTypeStateIssuer
01206OtherIAWELLMARK BCBS

Other providers in Iowa City, IA

All providers in Iowa City, IA · Nurse Practitioner in Iowa

Sources for this page

Verify at the official NPI Registry.