# SPENCER MUNICIPAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPENCER MUNICIPAL HOSPITAL
- **Other names:** Nurse Practitioner Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558548420
- **Legal business name:** SPENCER MUNICIPAL HOSPITAL
- **Authorized official:** BRENDA TIEFENTHALER (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (712) 264-6111

## Contact information

- **Practice address:** 2004 OKOBOJI AVE, MILFORD, IA 51351-1271
- **Practice address phone:** (712) 338-2461
- **Practice address fax:** (712) 262-2310
- **Mailing address:** 1200 1ST AVE E, SPENCER, IA 51301-4330
- **Mailing address phone:** (712) 264-6111
- **Mailing address fax:** (712) 264-6414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 210037H | IA | Yes |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 10/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1601120 | — | IA |