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COVENANT MEDICAL CENTER INC

Clinical Neuropsychologist

Waterloo, Iowa

Provider NPI: 1639110653

Organization Information:
Organization Name:  COVENANT MEDICAL CENTER INC
Organization is not Subpart
Authorized Official:  MICHELE MARIE PANICUCCI  SENIOR VP/CFO  319-2727359

Practice Location:
3421 W 9TH ST  WATERLOO, IA 50702 US
Tel: 319-272-7600  Fax: 319-272-7597

Business Mailing Address:
3421 W 9TH ST  WATERLOO, IA 50702 US
Tel: 319-272-7600  Fax: 319-272-7597

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist

Other Provider Identifiers:

IssuerNumberStateType
PTAN GROUPI14183IA01
PTAN INDIVIDUAL, DR. KARLA BRENNSCHEIDTI14183001IA01
PTAN INDIVIDUAL, DR JANE SPRINGERI14184IA01
NPI, KARLA BRENNSCHEIDT1104151471IA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS IA - Page 1

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