Ellerbroek, Renee R
Ellerbroek, Renee R is an individual health care provider with primary practice located at 4637 121St St , Urbandale IA 50323-2311. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Ellerbroek, Renee R can be contacted via phone (515) 655-7080.Contact Information
Primary practice address
4637 121St St
Urbandale IA 50323-2311
Phone: (515) 655-7080
Fax: (515) 655-7090
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 24490 | Iowa |
Profile Details
| NPI number | 1962510099 |
|---|---|
| LBN Legal business name | Ellerbroek, Renee R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2006 |
| Last updated | Jul 7th, 2023 - about 2 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 | 1962510099 | NPPES |
| Iowa | MEDICAID | 1041525 |
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