Countryman, Kim K
Countryman, Kim K is an sole proprietor health care provider with primary practice located at 120 Ne Dartmoor Dr , Waukee IA 50263. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Countryman, Kim K can be contacted via phone (515) 875-9890.Contact Information
Primary practice address
120 Ne Dartmoor Dr
Waukee IA 50263
Phone: (515) 875-9890
Fax: (515) 875-9892
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO-02312 | Iowa |
Profile Details
| NPI number | 1750382347 |
|---|---|
| LBN Legal business name | Countryman, Kim K |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 3rd, 2005 |
| Last updated | Oct 19th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750382347 | NPPES |
| Iowa | MEDICAID | 1043646 | |
| Iowa | Other | 59276 |
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