Reicks, Samantha Jo Mikota

Reicks, Samantha Jo Mikota is an individual health care provider with primary practice located at 901 Montgomery St , Decorah IA 52101-2325. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Reicks, Samantha Jo Mikota can be contacted via phone (563) 382-2911.

Contact Information

Primary practice address
901 Montgomery St Decorah IA 52101-2325
Phone: (563) 382-2911
Fax: (563) 387-3102
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A121332 Iowa

Profile Details

NPI number 1508208042
LBN Legal business name Reicks, Samantha Jo Mikota
Credentials DNP, ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2013
Last updated Sep 5th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508208042 NPPES
Iowa MEDICAID 1508208042

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