Individual
LISA K WOLTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1215 PLEASANT STREET, SUITE 400, DES MOINES, IA 50309-1418
(515) 241-5722
(515) 241-4403
Mailing address
1215 PLEASANT STREET, SUITE 400, DES MOINES, IA 50309-1418
(515) 241-5722
(515) 241-4403
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R143801-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0790683
—
IA
Enumeration date
01/02/2007
Last updated
12/13/2007
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