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 |