Provider Demographics
NPI:1396829834
Name:SPECHT, WILLIAM JOHN (ARNP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOHN
Last Name:SPECHT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:WAUKON
Mailing Address - State:IA
Mailing Address - Zip Code:52172-2022
Mailing Address - Country:US
Mailing Address - Phone:563-568-3411
Mailing Address - Fax:563-568-6139
Practice Address - Street 1:40 1ST ST SE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-2022
Practice Address - Country:US
Practice Address - Phone:563-568-3411
Practice Address - Fax:563-568-6139
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA088551363LA2100X
IAA-088551363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA28018OtherWELLMARK BC/BS IOWA
IA0730671Medicaid
IAP00385112OtherRAILROAD MEDICARE
IA0730671Medicaid
IAI18904Medicare PIN