| Lisa M Ducommun, CNP | |
|
300 Sioux Valley Dr, Cherokee, IA 51012-1205 | |
| (712) 225-6265 | |
| (712) 225-6800 |
| Full Name | Lisa M Ducommun |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 20 Years |
| Location | 300 Sioux Valley Dr, Cherokee, Iowa |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023105616 | NPI | - | NPPES |
| A-097930 | Other | IA | IOWA LICENSE |
| 0560631 | Medicaid | IA | |
| 27781 | Other | IA | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 364S00000X | Clinical Nurse Specialist | A-097930 (Iowa) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cherokee Regional Medical Center - Home Choice | Cherokee, IA | Home health agency |
| Cherokee Regional Medical Center Hospice | Cherokee, IA | Hospice |
| Cherokee Regional Medical Center | Cherokee, IA | Hospital |
| St Lukes Regional Medical Center | Sioux city, IA | Hospital |
| Buena Vista Regional Medical Center | Storm lake, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sioux Valley Memorial Hospital Association | 4880501881 | 19 |
| Sports Rehab And Professional Therapy Associates Inc | 1658289608 | 141 |
| Entity Name | Sioux Valley Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083610190 PECOS PAC ID: 4880501881 Enrollment ID: O20040317001463 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M Ducommun, CNP 300 Sioux Valley Dr, Cherokee, IA 51012-1205 Ph: (712) 225-6265 | Lisa M Ducommun, CNP 300 Sioux Valley Dr, Cherokee, IA 51012-1205 Ph: (712) 225-6265 |
Mrs. Janne L Johnson, ARNP Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1251 W Cedar Loop, Cherokee, IA 51012 Phone: 712-225-2594 Fax: 712-225-6933 |