Provider Demographics
NPI:1740953439
Name:GARCIA, WILMAR AUSTERO (FNP-C)
Entity type:Individual
Prefix:
First Name:WILMAR
Middle Name:AUSTERO
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 W PINEHURST TRL
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5234
Mailing Address - Country:US
Mailing Address - Phone:712-204-9094
Mailing Address - Fax:
Practice Address - Street 1:2730 PIERCE ST STE 300
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3765
Practice Address - Country:US
Practice Address - Phone:712-279-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA164470207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology