Individual
MICHELLE M MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
105 9TH AVE, BELLE PLAINE, IA 52208-2200
(319) 444-3210
(319) 444-4099
Mailing address
105 9TH AVE, BELLE PLAINE, IA 52208-2200
(319) 444-3210
(319) 444-4099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C087828
IA
363L00000X
Nurse Practitioner
Primary
C087828
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467449710
—
IA
01
—
500030815
RR MEDICARE
IA
01
—
72237
WELLMARK UIQC OCTC
IA
01
—
72238
WELLMARK UIQC SEIC
IA
01
—
72239
WELLMARK UIQC NL
IA
Enumeration date
10/03/2005
Last updated
03/05/2010
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