Individual
KEVIN J DIRKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(757) 561-4487
Mailing address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-8349
(319) 272-8355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6124
MN
363LA2100X
Acute Care Nurse Practitioner
2464790
MN
363LA2100X
Acute Care Nurse Practitioner
6124
MN
363LA2100X
Acute Care Nurse Practitioner
Primary
H161051
IA
Other
Enumeration date
08/21/2018
Last updated
10/20/2020
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