Hawthorn Wellness Clinic PLLC
Nurse Practitioner, Psych/Mental Health in North Liberty, IA. Organization (NPI-2).
NPI number1083469720
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1083469720
- Entity type
- Organization (NPI-2)
- Legal business name
- Hawthorn Wellness Clinic PLLC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2024
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Other names
- Hawthorn Wellness Clinic PLLC (Doing Business As)
Practice location
565 Cameron Way Ste 103North Liberty, IA 52317-4868
Phone 319-499-5410
Mailing address
320 Locust DrNorth Liberty, IA 52317-7801
Phone 319-621-9466
Authorized official
Allison Marie Donovan
Owner/Practioner
3196219466
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