Provider Demographics
NPI:1003271636
Name:GENGLER, MARY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:GENGLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:GENGLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:3500 SINGING HILLS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-5127
Mailing Address - Country:US
Mailing Address - Phone:605-217-7246
Mailing Address - Fax:605-217-4878
Practice Address - Street 1:3500 SINGING HILLS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-5127
Practice Address - Country:US
Practice Address - Phone:605-217-7246
Practice Address - Fax:605-217-4878
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily