Provider Demographics
NPI:1073497459
Name:OTTUMWA EXPRESS CLINIC
Entity type:Organization
Organization Name:OTTUMWA EXPRESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:641-436-7763
Mailing Address - Street 1:203 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2504
Mailing Address - Country:US
Mailing Address - Phone:641-436-7763
Mailing Address - Fax:
Practice Address - Street 1:203 W 2ND ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2504
Practice Address - Country:US
Practice Address - Phone:641-436-7763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care