# MERCY MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MercyOne Kingsley Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790723633
- **Authorized official:** JESICA HANSON (VP FINANCE)
- **Authorized official phone:** (712) 279-5850

## Contact information

- **Practice address:** 111 S MAIN ST, KINGSLEY, IA 51028-5021
- **Practice address phone:** (712) 378-2921
- **Practice address fax:** (712) 378-2965
- **Mailing address:** PO BOX 328, SIOUX CITY, IA 51102-0328
- **Mailing address phone:** (712) 279-5830
- **Mailing address fax:** (712) 279-5883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 10/18/2024