Individual
JUDITH A BOTTGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4405 HAMILTON BLVD, SIOUX CITY, IA 51104-1140
(712) 239-3937
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D042389
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040726
BLUE CROSS OF SD
SD
01
—
08652
BLUE CROSS OF NE
NE
05
—
10024954000
—
NE
05
—
2553990
—
IA
01
—
33480
BLUE CROSS OF IA
IA
05
—
3553990
—
IA
05
—
5753240
—
SD
01
—
7511
AVERA HEALTH PLANS
—
01
—
R013639
DAKOTACARE
—
Enumeration date
07/22/2005
Last updated
04/28/2008
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