Provider Demographics
NPI:1124401922
Name:HARTER, MARILYN (ARNP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:HARTER
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:515-643-9400
Mailing Address - Fax:515-643-9405
Practice Address - Street 1:412 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2947
Practice Address - Country:US
Practice Address - Phone:641-753-4021
Practice Address - Fax:641-753-4025
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA097804363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner