Individual
DEBRA LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 9TH ST SW, WAVERLY, IA 50677-2929
(319) 352-4340
Mailing address
312 9TH ST SW, WAVERLY, IA 50677-2929
(319) 352-4340
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A080874
IA
Other
Enumeration date
03/03/2014
Last updated
10/09/2015
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