Individual
MISS DEEANE MARIE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
194 6TH AVE NE, LE MARS, IA 51031-3716
(712) 546-3690
Mailing address
194 6TH AVE NE, LE MARS, IA 51031-3716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
59071
NE
363L00000X
Nurse Practitioner
Primary
1813
NE
363L00000X
Nurse Practitioner
A133056
IA
Other
Enumeration date
08/19/2008
Last updated
05/07/2013
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