Individual
MEGAN M VANOTTERLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP, FNP-C
Contact information
Practice address
1200 1ST AVE E, SPENCER, IA 51301-4330
(712) 264-6367
(712) 264-1526
Mailing address
1200 1ST AVE E, SPENCER, IA 51301-4330
(712) 264-6367
(712) 264-1526
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A112865
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720401961
WELLMARK
—
05
—
1720401961
—
IA
Enumeration date
01/23/2014
Last updated
02/22/2021
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