| Randy L Wirtz, ARNP | |
|
160 E Main St, Denver, IA 50622-9612 | |
| (319) 984-5645 | |
| (319) 984-5364 |
| Full Name | Randy L Wirtz |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 160 E Main St, Denver, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982681094 | NPI | - | NPPES |
| 0419940 | Medicaid | IA | |
| 2419440 | Medicaid | IA | |
| 38469 | Other | IA | WELLMARK BC/BS IOWA |
| P00195265 | Other | IA | RAILROAD MEDICARE |
| 3419440 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | A056327 (Iowa) | Primary |
| Entity Name | Waverly Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598959371 PECOS PAC ID: 8820996762 Enrollment ID: O20031230000129 |
| Mailing Address | Practice Location Address |
|---|---|
| Randy L Wirtz, ARNP 160 E Main St, Denver, IA 50622-9612 Ph: (319) 984-5645 | Randy L Wirtz, ARNP 160 E Main St, Denver, IA 50622-9612 Ph: (319) 984-5645 |
Mary S Knutson, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 111 Tower St, Denver, IA 50622 Phone: 319-984-5645 Fax: 319-984-5364 | |
Jennifer M Edeker, MSN, FNP, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 160 E Main Street, Denver, IA 50622 Phone: 319-984-5645 Fax: 319-984-5364 |