Provider Demographics
NPI:1023068111
Name:EHLERS, KIM M (ARNP)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:M
Last Name:EHLERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:M
Other - Last Name:SPLINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4100
Mailing Address - Fax:563-584-4110
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7313
Practice Address - Country:US
Practice Address - Phone:563-584-3430
Practice Address - Fax:563-584-3394
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-061850363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI7327Medicare ID - Type Unspecified
P70141Medicare UPIN