Basic Information
| Provider Information | |||||||||
| NPI: | 1891260444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURROUGHS | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20354 140TH ST | ||||||||
| Address2: | |||||||||
| City: | IOWA FALLS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501268554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156892354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 920 S OAK ST | ||||||||
| Address2: | |||||||||
| City: | IOWA FALLS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501269506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6416487000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2018 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A118989 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.