Individual
DR. DEBORAH R NIELSENDEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Mailing address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
28765
IA
207Q00000X
Family Medicine Physician
28765
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09642
IA BLUE SHIELD PROVIDER N
IA
05
—
6110353
—
IA
01
—
P00114109
RR MEDICARE PROVIDER NUMB
IA
Enumeration date
01/16/2006
Last updated
01/20/2022
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