Organization
WOMEN'S WELLNESS CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY S MCMAHON (ADMINISTRATIVE ASSISTAN)
(319) 233-3044
Entity
Organization
Contact information
Practice address
777 MAZZUCHELLI PL, DUBUQUE, IA 52001-7359
(563) 588-0011
(563) 588-0595
Mailing address
PO BOX 2400, WATERLOO, IA 50704-2400
(319) 233-3044
(319) 233-0722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38510
BLUE SHIELD
IA
Enumeration date
05/02/2006
Last updated
08/22/2020
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