Department of Veterans Affairs Outpatient Clinic

Primary specialty

VA Clinic/CenterTaxonomy code 261QV0200X

License

261QV0200X Issued in IA

Legal business name

DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC

Practice address

1015 S Hackett Rd
Waterloo, IA

Phone

(319) 235-1230

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie Tullis

Title

L.P.N.

Phone

(319) 234-3187

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851425276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 OAKWOOD DR",
            "city": "EVANSDALE",
            "state": "IA",
            "postal_code": "507071850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "telephone_number": "319-235-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TULLIS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "L.P.N.",
        "authorized_official_telephone_number": "319-234-3187"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "IA",
            "license": "261QV0200X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Delagardelle, LMSW
• Nicole Delagardelle, ARNP
• Toni Delagardelle, ARNP
• Ryan Stuart Dennis, CRNA
• Madison Denny-Weber
• Dermatology Associates PC
• Elizabeth Ann Derr, LISW
• Kelli Deserano, ARNP
• Michael L Deters, MD
• Mary Ellen Deutmeyer, A.R.N.P

• VA Clinic/Center in Waterloo, IA
• Providers in Waterloo, IA by specialty
• VA Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.