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Individual

JOHANNA B WHALEN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1230 E RUSHOLME ST, STE 301, DAVENPORT, IA 52803-2400
(563) 322-9150
(563) 322-9148
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4159
(563) 355-9191
(563) 355-3419

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
21524
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029185
HEALTH ALLIANCE
01
19970
IOWA HEALTH SOLUTIONS
01
40031
WELLMARK HEALTH PLAN
05
4009233
IA
01
4796890013
DMERC
01
IA0161
JOHN DEERE HEALTH PLAN
Enumeration date
06/24/2005
Last updated
07/09/2007
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