Individual
MRS. LISA LINN MOENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C PA-C
Contact information
Practice address
200 HAWKINS DRIVE, 1008 RCP, IOWA CITY, IA 52242
(319) 353-6360
(319) 353-7006
Mailing address
200 HAWKINS DRIVE, 1008 RCP, IOWA CITY, IA 52242
(319) 353-6360
(319) 353-7006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001221
IA
363A00000X
Physician Assistant
1862
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02392
WELLMARK BCBS
IA
Enumeration date
11/22/2005
Last updated
01/06/2012
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