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Organization
GREAT RIVER WOMEN'S HEALTH
Active
Organization
GREAT RIVER WOMEN'S HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A BAUER CMA (INSURANCE MGR)
(319) 752-4541
Entity
Organization
Contact information
Practice address
1223 S GEAR AVE, STE 208, WEST BURLINGTON, IA 52655-1682
(319) 752-4541
(319) 752-4541
Mailing address
1223 S GEAR AVE, STE 208, WEST BURLINGTON, IA 52655-1682
(319) 752-4541
(319) 752-4541
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123299
—
IA
01
—
51133
WELLMARK BCBS
IA
Enumeration date
03/27/2006
Last updated
08/22/2020
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