MS. ANDREA G DETTMANN-SPURGEON (NPI# 1346301892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346301892 |
| Entity Type | Individual |
| Full Name | MS. ANDREA G DETTMANN-SPURGEON |
| Credential | CPNP, ARNP |
| Practice Address |
2555 Berkshire Pkwy Ste A Clive IA 50325-4646 |
| Practice Telephone | 5159870051 |
| Practice Fax Number | 5159870054 |
| Mailing Telephone | 5159870051 |
| Mailing Fax Number | 5159870054 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-12-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
C-106794 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2555 BERKSHIRE PKWY STE A |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-4646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679544548 | Brian Leo Waggoner | Pediatrics | 2555 Berkshire Pkwy Ste A, Clive, IA 50325-4646 | 2006-01-30 |
| 1225572548 | Waggoner Pediatrics, Plc | Pediatrics | 2555 Berkshire Pkwy Ste A, Clive, IA 50325-4646 | 2016-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449446 | Clive Behavioral Health LLC | Psychiatric Hospital | 1500 Nw 114th St, Clive, IA 50325 | 2020-05-21 |
| 1609426519 | Caroline Silva Pereira Lara Ribeiro | Occupational Therapist | 15500 Boston Parkway, Appt 110, Clive, IA 50325 | 2019-09-13 |
| 1487203873 | Karen Turnure | Technician | 4524 Nw 16th St, Clive, IA 50325 | 2019-09-09 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1700288834 | Lindsey White | Chiropractor | 12931 University Ave, Suite 103, Clive, IA 50325 | 2014-09-19 |
| 1811337389 | Metro West Learning Center, LLC | Counselor | 13300 Hickman Rd Ste 110, Clive, IA 50325 | 2013-06-28 |
| 1700110343 | Rodolfo Mallorca Legislador Sr. | Family Medicine | 1665 Nw 97th St., Clive, IA 50325 | 2009-09-30 |
| 1891961900 | Erin Ducharme | Dermatology | 16349 Sheridan Drive, Suite 101, Clive, IA 50325 | 2008-05-08 |
| 1174792873 | The Iowa Clinic PC | Prosthetic/Orthotic Supplier | 12655 University Ave, Ste 160, Clive, IA 50325 | 2008-02-27 |
| 1164623393 | Melisa Coaker | Internal Medicine | 1275 Nw 128th St, Ste 200, Clive, IA 50325 | 2007-05-28 |
| Find all providers in zip 50325 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447225289 | Julie Ann Waggoner | Nurse Practitioner | 2555 Berkshire Pkwy, Clive, IA 50325-4646 | 2006-02-22 |
| 1265684229 | Samantha Schwenneker | Nurse Practitioner | 2555 Berkshire Pkwy, Clive, IA 50325-4646 | 2008-10-21 |
| 1114036266 | Lynn Howard | Nurse Practitioner | 1601 Nw 114th St, Suite 345, Clive, IA 50325-7007 | 2006-08-30 |
| 1629187679 | Julie Mclaren | Nurse Practitioner | 1601 Nw 114th St, Suite 345, Clive, IA 50325-7007 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455017 | Amy Danielle Dobberfuhl | Nurse Practitioner | 6833 Coburn Ln, Johnston, IA 50131-1243 | 2020-10-23 |
| 1326586249 | Abby Blacker | Nurse Practitioner | 10633 Nw 106th Ave, Granger, IA 50109-9775 | 2017-02-11 |
| 1457745986 | Amanda Larson | Nurse Practitioner | 420 12th St Se, Apt 16, Le Mars, IA 51031-2800 | 2015-03-23 |
| 1376951715 | Leslie Arends | Nurse Practitioner | 101 College of Nursing Building, 50 Newton Rd, Iowa City, IA 52242-1121 | 2014-07-29 |
| 1871928093 | Catherine Ann Roche | Nurse Practitioner | 5510 Utica Ridge Rd, Suite 100, Davenport, IA 52807-2946 | 2013-09-06 |
| 1063758605 | Blank Childrens Hospital | Nurse Practitioner | 6540 Ne 12th Ave, Pleasant Hill, IA 50327-8828 | 2013-01-01 |
| 1982984183 | Amanda Marie Ostergaard | Nurse Practitioner | 974 73rd Street, Suite 33, Windsor Heights, IA 50324-1026 | 2011-08-19 |
| 1831498146 | Julie Louise Ritland | Nurse Practitioner | 424 Kingbard Blvd, Waterloo, IA 50701-3056 | 2011-03-25 |
| 1033437140 | Teresa Dale Schenck | Nurse Practitioner | 400 N. 17th St, Teresa Schenck Dnp, Keokuk, IA 52632 | 2010-05-13 |
| 1538313614 | Susan E Rumelhart | Nurse Practitioner | 1243 20th St Sw, Cedar Rapids, IA 52404-1635 | 2008-11-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.