Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO-05222 | IA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | DO-05222 | IA |
NPI | 1316357494 |
---|---|
Provider Name | Kayla Leigh Ehrman |
First Address | Bettendorf, IA 52722-2799 |
Second Address | Bettendorf, IA 52722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 17/08/2021 |