Provider Demographics
NPI:1487855698
Name:NORTH IOWA FAMILY HEALTH CARE PLC
Entity Type:Organization
Organization Name:NORTH IOWA FAMILY HEALTH CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLLE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:641-423-4545
Mailing Address - Street 1:100 1ST ST NW
Mailing Address - Street 2:STE 140
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-3102
Mailing Address - Country:US
Mailing Address - Phone:641-423-4545
Mailing Address - Fax:641-423-4550
Practice Address - Street 1:100 1ST ST NW
Practice Address - Street 2:STE 140
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3102
Practice Address - Country:US
Practice Address - Phone:641-423-4545
Practice Address - Fax:641-423-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00439OtherBCBS OF IOWA
IA0481150Medicaid
IAQ55616Medicare UPIN
IAI16386Medicare PIN