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Individual

DAWN RENEE WANFALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP, NNP

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-2296
(319) 356-4855
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-2296
(319) 356-4855

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
085842
IA
363LN0000X
Neonatal Nurse Practitioner
Primary
K085842
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
70099
WELLMARK BCBS
IA
Enumeration date
06/21/2007
Last updated
08/26/2013
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