Basic Information
| Provider Information | |||||||||
| NPI: | 1770906109 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINZMANN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | LORENE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1288 VALLEY VIEW DR | ||||||||
| Address2: | |||||||||
| City: | COUNCIL BLUFFS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515035245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123288800 | ||||||||
| FaxNumber: | 7123288461 | ||||||||
| Practice Location | |||||||||
| Address1: | 3502 METRO DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COUNCIL BLUFFS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122567172 | ||||||||
| FaxNumber: | 7122567374 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2014 | ||||||||
| LastUpdateDate: | 09/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | A121973 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.