Organization
MERCY MEDICAL SERVICES
Active
Other names
Wakefield Mercy Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MONSMA (EXECUTIVE NETWORK DIRECTOR)
(712) 279-2925
Entity
Organization
Contact information
Practice address
308 ASH ST, WAKEFIELD, NE 68784-5023
(402) 287-2267
(402) 287-2267
Mailing address
PO BOX 328, SIOUX CITY, IA 51102-0328
(712) 279-5830
(712) 279-5883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252199-00
—
NE
Enumeration date
06/03/2006
Last updated
09/27/2007
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