Individual
MISTY D WAHAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
933 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4626
(712) 396-4360
(712) 396-7069
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A107947
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026327300
—
NE
05
—
1861929168
—
IA
Enumeration date
05/17/2017
Last updated
04/10/2019
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