Provider Demographics
NPI:1962497438
Name:MULDER, SHERYL ANN (ARNP MSN FNPC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:MULDER
Suffix:
Gender:F
Credentials:ARNP MSN FNPC
Other - Prefix:MRS
Other - First Name:SHERYL
Other - Middle Name:ANN
Other - Last Name:VELDHUIZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-7190
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1005 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-6413
Practice Address - Country:US
Practice Address - Phone:641-683-3195
Practice Address - Fax:641-683-3197
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074290163W00000X
IAA074290363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA45398OtherWELLMARK BCBS OF IA
P06811Medicare UPIN
IA3216994Medicaid
IA500022050OtherRAILROAD MEDICARE
IAI7858Medicare UPIN
IA156991OtherIOWA HEALTH SOLUTIONS
IA42068106086OtherJOHN DEER HEALTH
IAB002OtherTRIWEST