Individual
ANN MARIE WORDEKEMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 EDMUNDSON PL, COUNCIL BLUFFS, IA 51503-4658
(712) 396-4340
(712) 396-4180
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001158
IA
363A00000X
Physician Assistant
1477
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025464000
—
NE
05
—
10026480100
—
NE
05
—
1508813681
—
IA
05
—
47068731712
—
NE
05
—
47068731734
—
NE
05
—
47068731741
—
NE
05
—
47068731749
—
NE
05
—
47068731777
—
NE
05
—
47068731785
—
NE
Enumeration date
12/29/2005
Last updated
05/01/2017
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