ALENA DAVIDA ELLERBROEK (NPI# 1376858654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376858654 |
| Entity Type | Individual |
| Full Name | ALENA DAVIDA ELLERBROEK |
| Other Name | ALENA DAVIDA MARTINEZ |
| Credential | MSN,FNP |
| Practice Address |
441 E San Marnan Dr Suite 110 Waterloo IA 50702-5900 |
| Practice Telephone | 3192346000 |
| Practice Fax Number | 3192346001 |
| Mailing Telephone | 3192346000 |
| Mailing Fax Number | 3192346001 |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2015-11-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A123879 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
441 E SAN MARNAN DR SUITE 110 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790981207 | Justin Craig Ellerbroek | Dermatology | 441 E San Marnan Dr, Suite 110, Waterloo, IA 50702-5900 | 2007-06-22 |
| 1467898007 | Premier Dermatology, Ltd. | Dermatology | 441 E San Marnan Dr, Suite 110, Waterloo, IA 50702-5900 | 2013-05-21 |
| 1134411416 | Covenant Medical Center Inc | Durable Medical Equipment & Medical Supplies | 441 E San Marnan Dr, Waterloo, IA 50702-5900 | 2011-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020297 | Skye Aileen Warren | Nurse Practitioner | 5685 Summerland Dr, Waterloo, IA 50701-9597 | 2020-07-13 |
| 1255980710 | Stephanie Lynn Muertz | Nurse Practitioner | 6461 Old Orchard Ln, Waterloo, IL 62298-2136 | 2019-09-08 |
| 1760942767 | Christina E Lambert | Nurse Practitioner | 437 Alpine Dr, Waterloo, IL 62298-1086 | 2019-03-25 |
| 1235616293 | Nicole Christine Miller | Nurse Practitioner | 21 W Jefferson St Ste 103, Waterloo, IA 50701-1341 | 2018-07-23 |
| 1285129023 | Lindsay Ann Nie | Nurse Practitioner | 2140 Logan Ave, Waterloo, IA 50703-1020 | 2018-06-25 |
| 1376065318 | Nickayla L Giesemann | Nurse Practitioner | 212 W Dale St Ste 101, Waterloo, IA 50703-1900 | 2017-07-12 |
| 1831553908 | Theresa Mcfadin | Nurse Practitioner | 6100 Illini Trl, Waterloo, IL 62298-3547 | 2016-04-05 |
| 1376882647 | Shanna Witges | Nurse Practitioner | 509 Hamacher St Ste 102, Waterloo, IL 62298-1592 | 2013-02-06 |
| 1952640369 | Kimberly Elaine Glasgow | Nurse Practitioner | 1655 E San Marnan Dr Ste H, Waterloo, IA 50702-4378 | 2013-02-05 |
| 1417204355 | Ute E Gallert | Nurse Practitioner | 369 E. Main Street, Huntington Living Center, Waterloo, NY 13165 | 2012-08-09 |
| Find all providers in WATERLOO | ||||
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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.