Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | A110721 | IA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | A110721 | IA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | A110721 | IA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | A110721 | IA |
NPI | 1225538911 |
---|---|
Provider Name | Ms. Markie Lynn Vant Hul |
First Address | Le Mars, IA 51031 |
Second Address | Le Mars, IA 51031-2557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2018 |
Last Update Date | 31/08/2021 |