Provider Demographics
NPI:1992849350
Name:IOWA HEALTH
Entity Type:Organization
Organization Name:IOWA HEALTH
Other - Org Name:LA CLINICA
Other - Org Type:Other Name
Authorized Official - Title/Position:WOMEN'S HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HANNA-BERGEN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:515-266-4825
Mailing Address - Street 1:2679 MAURY ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-7462
Mailing Address - Country:US
Mailing Address - Phone:515-266-4825
Mailing Address - Fax:515-266-3105
Practice Address - Street 1:2679 MAURY ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-7462
Practice Address - Country:US
Practice Address - Phone:515-266-4825
Practice Address - Fax:515-266-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0005X
IAF-100358261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Not Answered261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health