Individual
PATRICK J PUCELIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
153 BLAIR ST, WHITING, IA 51063-1007
(712) 455-2431
(712) 455-2698
Mailing address
153 BLAIR ST, WHITING, IA 51063-1007
(712) 455-2431
(712) 455-2698
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
A-106028
IA
363L00000X
Nurse Practitioner
Primary
A-106028
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500018631
RAILROAD MEDICARE
—
Enumeration date
03/01/2006
Last updated
05/21/2008
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