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Organization
CHILD HEALTH SPECIALTY CLINICS
Active
Organization
CHILD HEALTH SPECIALTY CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN K SCHUELKE (GRANTS & CONTRACT MANAGER)
(319) 384-6674
Entity
Organization
Contact information
Practice address
100 HAWKINS DR., 247-A CDD, IOWA CITY, IA 52242
(319) 384-6674
(319) 356-3715
Mailing address
100 HAWKINS DR., 247-A CDD, IOWA CITY, IA 52242
(319) 384-6674
(319) 356-3715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
364SP0200X
Pediatric Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0480202
—
IA
05
—
0734871
—
IA
05
—
0736264
—
IA
05
—
0797431
—
IA
01
—
1053503755
NPI
IA
01
—
1225177579
NPI
IA
01
—
1609915628
NPI
IA
Enumeration date
08/28/2006
Last updated
06/18/2008
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