Individual
MACKENZIE JANE GROTELUSCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 398-6037
(319) 198-6046
Mailing address
1917 C AVE NE, CEDAR RAPIDS, IA 52402-5306
(515) 451-1493
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
114127
IA
Other
Enumeration date
09/16/2012
Last updated
09/16/2012
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