Provider Demographics
NPI:1003461518
Name:MVP INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:MVP INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/ CO-OWNER /PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VANT HUL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:712-470-1498
Mailing Address - Street 1:1221 PIERCE STREET
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105
Mailing Address - Country:US
Mailing Address - Phone:712-255-0204
Mailing Address - Fax:712-255-1120
Practice Address - Street 1:1221 PIERCE STREET
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105
Practice Address - Country:US
Practice Address - Phone:712-255-0204
Practice Address - Fax:712-255-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty