Individual
JOANNA KAY OBERBROECKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2979 VICTORIA ST, BETTENDORF, IA 52722-2784
(563) 332-8528
Mailing address
2319 E 32ND ST, DAVENPORT, IA 52807-2207
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
J048928
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0474809
—
IA
Enumeration date
08/30/2006
Last updated
07/08/2007
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