Organization
CEDAR RAPIDS MEDICAL EDUCATION FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER C. HOLMES LATTERELL D.O. (EXECUTIVE DIRECTOR)
(319) 297-2300
Entity
Organization
Contact information
Practice address
1260 SECOND AVENUE S.E., CEDAR RAPIDS, IA 52403
(319) 297-2300
(319) 297-2280
Mailing address
1260 SECOND AVENUE S.E., CEDAR RAPIDS, IA 52403
(319) 297-2300
(319) 297-2280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22013
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558349589
NPI
IA
01
—
1639226921
NPI
IA
Enumeration date
04/08/2008
Last updated
05/18/2015
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