Individual
LYNN MARIE MOORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
210 4TH AVE, GRINNELL, IA 50112-1898
(641) 236-2382
Mailing address
210 4TH AVE, GRINNELL, IA 50112-1898
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A-114681
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IA
Enumeration date
02/12/2018
Last updated
06/16/2018
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