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Individual

DEBRA SUSAN ELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3330
(319) 353-8430
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3330
(319) 353-8430

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001330
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26592
WELLMARK BCBS
IA
Enumeration date
09/27/2005
Last updated
11/29/2007
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