Basic Information
| Provider Information | |||||||||
| NPI: | 1548720998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UHLENHOPP | ||||||||
| FirstName: | LIBBY | ||||||||
| MiddleName: | KATRINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 EASTON AVE | ||||||||
| Address2: | |||||||||
| City: | WAVERLY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 506779799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194647915 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 TOWER ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | IA | ||||||||
| PostalCode: | 506222201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3199845645 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2019 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 137651 | IA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363LF0000X | A154699 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 137651 | 01 | IA | IOWA BOARD OF NURSING | OTHER | A154699 | 01 | IA | IOWA BOARD OF NURSING | OTHER |