| Heartland Pathways Inc | |
|
1626 Morgan St Keokuk IA 52632-3420 | |
| (319) 249-5777 | |
| Not Available |
| Full Name | Heartland Pathways Inc |
|---|---|
| Speciality | Counselor |
| Location | 1626 Morgan St, Keokuk, Iowa |
| Authorized Official Name and Position | Kristin Suminski (VICE PRESIDENT) |
| Authorized Official Contact | 3192495777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Pathways Inc 1626 Morgan St Ste 4 Keokuk IA 52632-3424 Ph: (319) 249-5777 | Heartland Pathways Inc 1626 Morgan St Keokuk IA 52632-3420 Ph: (319) 249-5777 |
| NPI Number | 1053824193 |
|---|---|
| Provider Enumeration Date | 11/12/2017 |
| Last Update Date | 01/27/2019 |
| Medicare PECOS PAC ID | 6709139306 |
|---|---|
| Medicare Enrollment ID | O20181029002928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053824193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 178005136 (Illinois) | Primary |
| 101YM0800X | Counselor - Mental Health | 00839 (Iowa) | Secondary |
| Provider Name | Patricia Lou Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770587719 PECOS PAC ID: 0941455117 Enrollment ID: I20130220000167 |
| Provider Name | Nan L Ambrosy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144325648 PECOS PAC ID: 4981597978 Enrollment ID: I20151016001336 |
| Provider Name | Jamey L Washburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023554029 PECOS PAC ID: 1355625476 Enrollment ID: I20170308001675 |
| Provider Name | Alicia Johanna Logan-soper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225505688 PECOS PAC ID: 1850755141 Enrollment ID: I20230920000858 |
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