Provider Demographics
NPI:1699177360
Name:HITTENMILLER, TRISHA (ARNP)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:HITTENMILLER
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 1:12499 UNIVERSITY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8281
Mailing Address - Country:US
Mailing Address - Phone:515-418-9960
Mailing Address - Fax:515-418-9107
Practice Address - Street 1:12499 UNIVERSITY AVE
Practice Address - Street 2:STE 200
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8281
Practice Address - Country:US
Practice Address - Phone:515-418-9960
Practice Address - Fax:515-418-9107
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA115986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily