Individual
HEATHER ROSE KREBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1326
(712) 279-2010
(712) 279-2034
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002079
IA
363AM0700X
Medical Physician Assistant
Primary
002079
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002079
PA LICENSE
IA
01
—
1091016
NCCPA
—
01
—
5101342
STATE CSC
IA
Enumeration date
03/30/2010
Last updated
03/07/2023
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