Basic Information
Provider Information
NPI: 1649827965
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRIESER
FirstName: LINDSEY
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HECKES
OtherFirstName: LINDSEY
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: ARNP
OtherLastNameType: 1
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193564155
FaxNumber: 3193563891
Practice Location
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193564155
FaxNumber: 3193563891
Other Information
ProviderEnumerationDate: 08/21/2019
LastUpdateDate: 08/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XA155251IAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XA155251IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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