Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A160216 | IA |
NPI | 1003421959 |
---|---|
Provider Name | Elizabeth Ann Myhr |
First Address | Ankeny, IA 50021-9224 |
Second Address | Ankeny, IA 50021-9224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 08/09/2020 |