Provider Demographics
NPI:1831645308
Name:GULATTO, MAUREEN (ARNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:GULATTO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:M
Other - Last Name:RIEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4028
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61204-4028
Mailing Address - Country:US
Mailing Address - Phone:563-355-9200
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:1801 E 54TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-7209
Practice Address - Country:US
Practice Address - Phone:563-421-0550
Practice Address - Fax:563-421-0559
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA131740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily