Provider Demographics
NPI:1770558025
Name:HONNER, DENISE L (PA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:HONNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:REIFKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:818 5TH AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1303
Mailing Address - Country:US
Mailing Address - Phone:877-811-7526
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:1604 2ND AVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501
Practice Address - Country:US
Practice Address - Phone:877-811-7526
Practice Address - Fax:515-280-7525
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001569363A00000X
IA001569PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant