Provider Demographics
NPI:1750004891
Name:INTEGRATED HEALTHCARE OF IOWA, PLLC
Entity type:Organization
Organization Name:INTEGRATED HEALTHCARE OF IOWA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED INDIVIDUAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PRISNER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-BC PMHNP-BC
Authorized Official - Phone:319-209-2150
Mailing Address - Street 1:903 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4608
Mailing Address - Country:US
Mailing Address - Phone:319-209-2150
Mailing Address - Fax:319-209-2149
Practice Address - Street 1:903 OAK ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4608
Practice Address - Country:US
Practice Address - Phone:319-209-2150
Practice Address - Fax:319-209-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty