Organization
SIOUXLAND REGIONAL CANCER CENTER
Active
Other names
JUNE E NYLEN CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTA J MCCULLOUGH (EXECUTIVE DIRECTOR)
(712) 252-9301
Entity
Organization
Contact information
Practice address
230 NEBRASKA ST, SIOUX CITY, IA 51101-1733
(712) 252-0088
(712) 252-9404
Mailing address
PO BOX 5017, SIOUX CITY, IA 51102-5017
(712) 252-9301
(712) 252-9337
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460568
—
IA
05
—
10025264400
—
NE
01
—
50928
WELLMARK
IA
Enumeration date
12/27/2005
Last updated
06/24/2019
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