Organization
MERCY MEDICAL SERVICES
Active
Other names
MercyOne Kingsley Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JESICA HANSON (VP FINANCE)
(712) 279-5850
Entity
Organization
Contact information
Practice address
111 S MAIN ST, KINGSLEY, IA 51028-5021
(712) 378-2921
(712) 378-2965
Mailing address
PO BOX 328, SIOUX CITY, IA 51102-0328
(712) 279-5830
(712) 279-5883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0638676
—
IA
Enumeration date
06/03/2006
Last updated
10/18/2024
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