Provider Demographics
NPI:1851386791
Name:BJORNSEN, KATHERINE D (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:D
Last Name:BJORNSEN
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 1:200 HAWKINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1082
Mailing Address - Country:US
Mailing Address - Phone:319-356-7316
Mailing Address - Fax:319-356-4693
Practice Address - Street 1:200 HAWKINS DRIVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1082
Practice Address - Country:US
Practice Address - Phone:319-356-7316
Practice Address - Fax:319-356-4693
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC073546363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0417436Medicaid
IA24395OtherWELLMARK BCBS
P12756Medicare UPIN
IA0417436Medicaid