Basic Information
Provider Information
NPI: 1548692585
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAGGETT
FirstName: ANNE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: APN, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FREUDENBERG
OtherFirstName: ANNE
OtherMiddleName: M
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3194676789
FaxNumber: 3194676600
Practice Location
Address1: 3640 MIDDLEBURY RD
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522452712
CountryCode: US
TelephoneNumber: 3194676789
FaxNumber: 3194676600
Other Information
ProviderEnumerationDate: 08/01/2013
LastUpdateDate: 12/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XA155272IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X0991856CON Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
163W00000X1619038CON Nursing Service ProvidersRegistered Nurse 
363LF0000XA155272IAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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