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Individual

CAROLE DIANE LIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
4280 SERGEANT RD, SUITE 230, SIOUX CITY, IA 51106-4634
(712) 274-6884
(712) 274-6885
Mailing address
4280 SERGEANT RD, SUITE 230, SIOUX CITY, IA 51106-4634
(712) 274-6884
(712) 274-6885

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A-050932
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548246838
NPI
IA
Enumeration date
12/19/2005
Last updated
09/30/2013
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