Individual
RANDY L WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
160 E MAIN ST, DENVER, IA 50622-9612
(319) 984-5645
(319) 984-5364
Mailing address
160 E MAIN ST, DENVER, IA 50622-9612
(319) 984-5645
(319) 984-5364
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A056327
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419940
—
IA
05
—
2419440
—
IA
05
—
3419440
—
IA
01
—
38469
WELLMARK BC/BS IOWA
IA
01
—
P00195265
RAILROAD MEDICARE
IA
Enumeration date
12/29/2005
Last updated
10/22/2007
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