Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | K086572 | IA |
NPI | 1194043190 |
---|---|
Provider Name | Cynthia D Waters |
First Address | Iowa City, IA 52242-1007 |
Second Address | Iowa City, IA 52242-1007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 14/05/2010 |