Provider Demographics
NPI:1518951680
Name:HIMMELREICH, LYNNE D (ARNP CNM)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:D
Last Name:HIMMELREICH
Suffix:
Gender:F
Credentials:ARNP CNM
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:DETTE
Other - Last Name:STEELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-7002
Mailing Address - Fax:319-356-7556
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-7002
Practice Address - Fax:319-356-7556
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB093262367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA51951OtherWELLMARK BCBS
IA0420786Medicaid
IA0420786Medicaid
S91302Medicare UPIN
IA49997Medicare PIN
IA51951OtherWELLMARK BCBS