Provider Demographics
NPI:1376065318
Name:GIESEMANN, NICKAYLA L (ARNP)
Entity Type:Individual
Prefix:
First Name:NICKAYLA
Middle Name:L
Last Name:GIESEMANN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NICKAYLA
Other - Middle Name:L
Other - Last Name:NOSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 W DALE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-1900
Mailing Address - Country:US
Mailing Address - Phone:319-274-6771
Mailing Address - Fax:319-274-6777
Practice Address - Street 1:212 W DALE ST STE 101
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1900
Practice Address - Country:US
Practice Address - Phone:319-274-6771
Practice Address - Fax:319-274-6777
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA138197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily