| Ms Emily Wickham, | |
|
3434 W Broadway Ste 100, Council Bluffs, IA 51501-3291 | |
| (712) 325-0022 | |
| Not Available |
| Full Name | Ms Emily Wickham |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Primary Care |
| Location | 3434 W Broadway Ste 100, Council Bluffs, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073254439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 114078 (Nebraska) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | A174602 (Iowa) | Primary |
| Entity Name | Bluffs Family Health Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194898296 PECOS PAC ID: 0446298061 Enrollment ID: O20070117000205 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Emily Wickham, 3434 W Broadway Ste 100, Council Bluffs, IA 51501-3291 Ph: (712) 325-0022 | Ms Emily Wickham, 3434 W Broadway Ste 100, Council Bluffs, IA 51501-3291 Ph: (712) 325-0022 |
Jennifer L Achenbach, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 800 Mercy Dr, Council Bluffs, IA 51503 Phone: 712-325-2484 | |
Mallory Lloyd, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 808 E Pierce St, Council Bluffs, IA 51503 Phone: 402-740-6503 | |
Michelle Rude, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 933 E Pierce St, Council Bluffs, IA 51503 Phone: 712-396-4360 Fax: 712-396-7069 | |
Laura M Ayers, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 North Ave Ste 8, Council Bluffs, IA 51503 Phone: 712-796-2545 Fax: 712-847-6095 | |
Shannon Ranae Stafford, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1604 2nd Ave, Council Bluffs, IA 51501 Phone: 712-322-6650 Fax: 712-328-7985 | |
Brian Luedke, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 933 E Pierce St, Council Bluffs, IA 51503 Phone: 712-396-4360 Fax: 712-396-7069 |