Individual
MRS. MICHELLE DIANE ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3605
(319) 356-3901
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3605
(319) 356-3901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A105879
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72213
WELLMARK BCBS
IA
Enumeration date
08/30/2007
Last updated
04/30/2008
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