1154322402 NPI number — MS. LINDA LOU GRAUER CRNA ARNP

Table of content: MS. LINDA LOU GRAUER CRNA ARNP (NPI 1154322402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154322402 NPI number — MS. LINDA LOU GRAUER CRNA ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAUER
Provider First Name:
LINDA
Provider Middle Name:
LOU
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154322402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1604 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEROKEE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51012-1563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-225-2084
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 SIOUX VALLEY DR
Provider Second Line Business Practice Location Address:
CHEROKEE REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
CHEROKEE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51012-1205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-225-5101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  074490 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)