Provider Demographics
| NPI: | 1184992380 |
|---|---|
| Name: | NORTH IOWA MERCY CLINICS |
| Entity type: | Organization |
| Organization Name: | NORTH IOWA MERCY CLINICS |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VP/FINANCE |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DANETTE |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | ZOOK |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 641-428-7989 |
| Mailing Address - Street 1: | 621 S ILLINOIS AVE |
| Mailing Address - Street 2: | SUITE 103 |
| Mailing Address - City: | MASON CITY |
| Mailing Address - State: | IA |
| Mailing Address - Zip Code: | 50401-5405 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 641-428-5100 |
| Mailing Address - Fax: | 641-428-3059 |
| Practice Address - Street 1: | 1010 4TH ST SW |
| Practice Address - Street 2: | SUITE 32 |
| Practice Address - City: | MASON CITY |
| Practice Address - State: | IA |
| Practice Address - Zip Code: | 50401-2857 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 641-428-5100 |
| Practice Address - Fax: | 641-428-5115 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2011-12-02 |
| Last Update Date: | 2020-11-24 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |