NPI 1346301892 · live from the CMS NPI Registry
Andrea G Dettmann-Spurgeon, CPNP, ARNP
Nurse Practitioner, Pediatrics in Clive, IA. National Provider Identifier 1346301892, active.
NPI record
| NPI | 1346301892 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 2555 Berkshire Pkwy Ste A, Clive, IA 50325 |
| Practice phone | 515-987-0051 |
| Enumerated | December 12, 2006 |
| Last updated | December 23, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | C-106794 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.