Provider Demographics
NPI:1841076528
Name:MISTER, JOAN M (RN)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:MISTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-5705
Mailing Address - Country:US
Mailing Address - Phone:833-370-0719
Mailing Address - Fax:515-220-2272
Practice Address - Street 1:405 E 5TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-5705
Practice Address - Country:US
Practice Address - Phone:833-370-0719
Practice Address - Fax:515-220-2272
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082528163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health