Provider Demographics
NPI:1518704592
Name:MALLARI, BOBBIE LONA (ARNP AGPCNP)
Entity type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:LONA
Last Name:MALLARI
Suffix:
Gender:F
Credentials:ARNP AGPCNP
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:LONA
Other - Last Name:NIENKARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:918 W PLATT ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-2063
Mailing Address - Country:US
Mailing Address - Phone:563-652-5145
Mailing Address - Fax:
Practice Address - Street 1:918 W PLATT ST STE 1
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-2063
Practice Address - Country:US
Practice Address - Phone:563-652-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH186254363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health