Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 114150 | IA |
NPI | 1053463455 |
---|---|
Provider Name | Mary Ramen |
First Address | Ames, IA 50011-2260 |
Second Address | Ames, IA 50011-2260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |