Provider Demographics
NPI:1609871649
Name:DELLOS, LAURA M (ARNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:DELLOS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:L
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
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:319-356-7038
Mailing Address - Fax:319-384-2406
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:319-356-7038
Practice Address - Fax:319-384-2406
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB-100854367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1419598Medicaid
IA0125OtherJOHN DEERE HEALTH PLAN
064372OtherHEALTH ALLIANCE
IA25663OtherWELLMARK BCBS
147377OtherIOWA HEALTH SOLUTIONS
IA29597Other29597
IA0419598Medicaid
4796890005OtherDMERC
500018810Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IAI3088Medicare PIN
147377OtherIOWA HEALTH SOLUTIONS
IA1419598Medicaid
IAI1421016Medicare PIN