Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 078876 | IA |
Y | 111NP0017X | Pediatric Chiropractor | 078876 | IA |
NPI | 1114317740 |
---|---|
Provider Name | Nicole Ramirez |
First Address | Urbandale, IA 50322-2000 |
Second Address | Urbandale, IA 50322-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 13/03/2019 |