Provider Demographics
NPI:1083102933
Name:PTACEK, COLOMBIA ESTHER (ARNP)
Entity Type:Individual
Prefix:
First Name:COLOMBIA
Middle Name:ESTHER
Last Name:PTACEK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-222-7600
Mailing Address - Fax:515-222-7601
Practice Address - Street 1:1601 NW 114TH ST STE 342
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7036
Practice Address - Country:US
Practice Address - Phone:515-222-7600
Practice Address - Fax:515-222-7601
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA121580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily