Provider Demographics
NPI:1679081327
Name:KAUZLARICH, SHEILA KAE (ARNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:KAE
Last Name:KAUZLARICH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:KAE
Other - Last Name:MOORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:641-682-5349
Mailing Address - Fax:515-246-4474
Practice Address - Street 1:1005 PENNSYLVANIA AVE STE 207
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-6414
Practice Address - Country:US
Practice Address - Phone:641-682-5349
Practice Address - Fax:515-246-4474
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA117848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner