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Individual

LISA R KONGABLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-6963
(319) 356-2587
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-6963
(319) 356-2587

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
T-076356
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0438127
IA
01
24739
MIDLANDS
IA
01
463848
VALUE OPTIONS RAILROAD
IA
01
500029110
RAILROAD MEDICARE
IA
01
59200
WELLMARK
IA
Enumeration date
08/05/2006
Last updated
12/09/2019
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