# GREAT RIVER WOMEN'S HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902866478
- **Authorized official:** LISA A BAUER CMA (INSURANCE MGR)
- **Authorized official phone:** (319) 752-4541

## Contact information

- **Practice address:** 1223 S GEAR AVE, STE 208, WEST BURLINGTON, IA 52655-1682
- **Practice address phone:** (319) 752-4541
- **Practice address fax:** (319) 752-4541
- **Mailing address:** 1223 S GEAR AVE, STE 208, WEST BURLINGTON, IA 52655-1682
- **Mailing address phone:** (319) 752-4541
- **Mailing address fax:** (319) 752-4541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0123299 | — | IA |
| 01 | — | 51133 | WELLMARK BCBS | IA |