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Organization
BOONE COUNTY FAMILY MEDICINE TR
Active
Organization
BOONE COUNTY FAMILY MEDICINE TR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKAELA KIENITZ (CEO)
(515) 432-3140
Entity
Organization
Contact information
Practice address
1115 S MARSHALL ST, BOONE, IA 50036-5304
(515) 432-2335
(515) 432-2357
Mailing address
1115 S MARSHALL ST, BOONE, IA 50036-5304
(515) 432-2335
(515) 432-2357
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/17/2006
Last updated
07/01/2026
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