Provider Demographics
NPI:1730198508
Name:GIESSELMANN, VICKI JOANNE SEASE (ARNP)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:JOANNE SEASE
Last Name:GIESSELMANN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 NEWBURY COURT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131
Mailing Address - Country:US
Mailing Address - Phone:515-334-5424
Mailing Address - Fax:
Practice Address - Street 1:1601 NW 114TH ST
Practice Address - Street 2:SUITE 247
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7007
Practice Address - Country:US
Practice Address - Phone:515-222-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA086246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0456681Medicaid
IAI14841Medicare ID - Type Unspecified
IA0456681Medicaid