Provider Demographics
NPI:1568894731
Name:GARTIN, MARY HELEN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:GARTIN
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 1:2000C SOUTH MAIN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556
Mailing Address - Country:US
Mailing Address - Phone:641-472-4141
Mailing Address - Fax:641-469-3516
Practice Address - Street 1:2000C SOUTH MAIN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556
Practice Address - Country:US
Practice Address - Phone:641-472-4141
Practice Address - Fax:641-469-3516
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA089557207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA089557OtherIOWA LICENSE