ANDREA KAYE DIETZENBACH (NPI# 1205141835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205141835 |
| Entity Type | Individual |
| Full Name | ANDREA KAYE DIETZENBACH |
| Other Name | ANDREA KAYE JIRAK |
| Credential | P.A. |
| Practice Address |
110 Jefferson St West Union IA 52175-1022 |
| Mailing Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 5634223817 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2015-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002140 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
110 JEFFERSON ST |
| City | WEST UNION |
| State | IA |
| Zip Code | 52175-1022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031883 | Kenneth A Miller | Family Medicine | 110 Jefferson St, West Union, IA 52175-1022 | 2005-05-27 |
| 1639533763 | Palmer Lutheran Health Center, Inc | Clinic/Center | 110 Jefferson St, West Union, IA 52175-1022 | 2016-04-05 |
| 1699131474 | Carina Crookston | Family Medicine | 110 Jefferson St, West Union, IA 52175-1022 | 2016-01-08 |
| 1013380138 | Samuel D Brauer | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2015-11-11 |
| 1184900755 | Kirstin Dana Nelson-lerch | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2011-10-27 |
| 1043257496 | Geralyn R Zuercher | Family Medicine | 110 Jefferson St, West Union, IA 52175-1022 | 2006-06-01 |
| 1730132010 | Vicki Lynn Novak | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2006-05-18 |
| 1487606406 | Gundersen Clinic, Ltd. | Clinic/Center | 110 Jefferson St, West Union, IA 52175-1022 | 2006-05-17 |
| 1780689174 | Denise I Tinker | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2005-06-14 |
| 1235134594 | Darcy H Connelly | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2005-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073051355 | Kyle Brandt | Physical Therapy Assistant | 112 W Jefferson Street, West Union, IA 52175 | 2017-02-07 |
| 1225188378 | Lew D. Bishop | Audiologist | 6908 Echo Valley Rd., West Union, IA 52175 | 2007-01-11 |
| 1598765398 | Palmer Lutheran Health Center, Inc. | General Acute Care Hospital | 112 Jefferson Street, West Union, IA 52175 | 2005-07-22 |
| 1578842308 | Brittany Rose O'brien | Physical Therapy Assistant | 112 Jefferson St, West Union, IA 52175 | 2011-08-10 |
| 1467666792 | Garvin Moser LLC | Assisted Living Facility | 705 S Pine St, West Union, IA 52175 | 2007-05-09 |
| 1891841441 | Palmer Lutheran Health Center, Inc | Nurse Anesthetist, Certified Registered | 112 Jefferson Street, West Union, IA 52175 | 2007-01-26 |
| 1649350893 | David C. White | Emergency Medicine | 112 Jefferson St, West Union, IA 52175 | 2006-10-16 |
| 1023042686 | Richard Yngve Jacobson Jr. | Nurse Anesthetist, Certified Registered | 112 Jefferson St, West Union, IA 52175 | 2006-07-10 |
| 1801845110 | Palmer Lutheran Health Center, Inc | Clinic/Center | 112 Jefferson Street, West Union, IA 52175 | 2006-05-06 |
| 1265481576 | Palmer Lutheran Health Center, Inc. | Medicare Defined Swing Bed Unit | 112 Jefferson Street, West Union, IA 52175 | 2006-05-06 |
| Find all providers in zip 52175 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184900755 | Kirstin Dana Nelson-lerch | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2011-10-27 |
| 1730132010 | Vicki Lynn Novak | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2006-05-18 |
| 1780689174 | Denise I Tinker | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2005-06-14 |
| 1235134594 | Darcy H Connelly | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2005-06-14 |
| 1831191899 | Bruce C Baker | Physician Assistant | 110 Jefferson St, West Union, IA 52175-1022 | 2005-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306468434 | Nichole Marie Steffens | Physician Assistant | 2371 County Road B32, Fort Atkinson, IA 52144-7414 | 2020-05-12 |
| 1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
| 1295282325 | Courtney Lowy | Physician Assistant | 3850 Merle Hay Rd Ste 500, Des Moines, IA 50310-1322 | 2016-09-07 |
| 1447641618 | West Broadway Clinic, P.C. | Physician Assistant | 1701 W Broadway, Council Bluffs, IA 51501-3822 | 2015-02-10 |
| 1972858397 | Sarah Beth Nace | Physician Assistant | 2346 Mormon Trek Blvd Ste 1500, Iowa City, IA 52246-4368 | 2012-07-23 |
| 1528313350 | Stephanie Elaine Fangman | Physician Assistant | 709 W Main St Ste 3, Manchester, IA 52057-1526 | 2012-07-18 |
| 1679707947 | Integrative Medicine Consultants, Inc. | Physician Assistant | 507 Main Avenue, Clear Lake, IA 50428 | 2009-05-14 |
| 1992960876 | Cass County Memorial Hospital Rhc | Physician Assistant | 1501 E 10th St Ste 100, Atlantic, IA 50022-1936 | 2008-07-21 |
| 1629265368 | Hannah Joy Lokenvitz | Physician Assistant | 700 2nd St Se Ste 101, Hampton, IA 50441-2655 | 2007-09-26 |
| 1568658532 | Angela K Grundmeyer | Physician Assistant | 1215 Pleasant St Ste 100, Des Moines, IA 50309-1409 | 2007-09-24 |
| Find all providers with the same taxonomy | ||||
| City | WEST UNION |
| Zip Code | 52175 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.