Individual
DENISE ELAINE ANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, MSN, CCNS
Contact information
Practice address
1236 E RUSHOLME ST, DAVENPORT, IA 52803-2473
(563) 421-3994
(563) 421-3999
Mailing address
815 WAVERLY RD, DAVENPORT, IA 52804-4330
(563) 326-4499
Taxonomy
Speciality
Code
Description
License number
State
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
Primary
055474
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16064
WELLMARK BCBS
IA
05
—
436543
—
IA
01
—
506291
IOWA HEALTH SOLUTION
—
Enumeration date
01/11/2007
Last updated
07/08/2007
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