Provider Demographics
NPI:1861500910
Name:CAPPER, VONDA JOLENE (OD)
Entity type:Individual
Prefix:
First Name:VONDA
Middle Name:JOLENE
Last Name:CAPPER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:VONDA
Other - Middle Name:JOLENE
Other - Last Name:CAPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:307 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50421-1124
Mailing Address - Country:US
Mailing Address - Phone:641-444-3380
Mailing Address - Fax:641-444-3929
Practice Address - Street 1:307 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMOND
Practice Address - State:IA
Practice Address - Zip Code:50421-1124
Practice Address - Country:US
Practice Address - Phone:641-423-8861
Practice Address - Fax:641-423-0727
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0484568Medicaid
U52407Medicare UPIN
IA0484568Medicaid