Organization
COVENANT MEDICAL CENTER INC
Active
Organization
COVENANT MEDICAL CENTER INC
Active
Other names
MercyOne Waterloo Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY HUBER (CONTROLLER)
(319) 272-7607
Entity
Organization
Contact information
Practice address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-7600
(319) 272-7597
Mailing address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-7600
(319) 272-7597
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104151471
NPI, KARLA BRENNSCHEIDT
IA
01
—
I14183
PTAN GROUP
IA
01
—
I14183001
PTAN INDIVIDUAL, DR. KARLA BRENNSCHEIDT
IA
01
—
I14184
PTAN INDIVIDUAL, DR JANE SPRINGER
IA
Enumeration date
06/09/2006
Last updated
10/10/2024
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