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8860 Northpark Dr Ste 200 Urbandale IA 50131-3168 | |
(708) 522-5439 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 8860 Northpark Dr Ste 200, Urbandale, Iowa |
Authorized Official Name and Position | Audrey K Gries (PHYSICIAN ASSISTANT / CO-OWNER) |
Authorized Official Contact | 7085225439 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8860 Northpark Dr Ste 200 Urbandale IA 50131-3168 Ph: () - | 8860 Northpark Dr Ste 200 Urbandale IA 50131-3168 Ph: (708) 522-5439 |
NPI Number | 1437902749 |
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Provider Enumeration Date | 04/08/2024 |
Last Update Date | 04/09/2024 |
Medicare PECOS PAC ID | 4587102546 |
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Medicare Enrollment ID | O20240821002934 |
Identifier | Type | State | Issuer |
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1437902749 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Stephanie L Erdmann |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952552655 PECOS PAC ID: 0547457673 Enrollment ID: I20101215000137 |
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