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2712 Orchard Drive Suite B Cedar Falls IA 50613-4235 | |
(319) 404-2262 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 2712 Orchard Drive Suite B, Cedar Falls, Iowa |
Authorized Official Name and Position | Angela Devries (OWNER) |
Authorized Official Contact | 3194042262 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2712 Orchard Drive Suite B Cedar Falls IA 50613-6100 Ph: (319) 404-2262 | 2712 Orchard Drive Suite B Cedar Falls IA 50613-4235 Ph: (319) 404-2262 |
NPI Number | 1356802631 |
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Provider Enumeration Date | 03/28/2019 |
Last Update Date | 10/13/2019 |
Medicare PECOS PAC ID | 2365876794 |
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Medicare Enrollment ID | O20191218000883 |
Identifier | Type | State | Issuer |
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1356802631 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Provider Name | Angela F Devries |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821472556 PECOS PAC ID: 3072829183 Enrollment ID: I20150904000156 |
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