IndividualActive
Brooke Mactaggart, CPNP-PC
NPI 1194507954 · Pediatric Nurse Practitioner · Manchester, IA
Provider details
- NPI number
- 1194507954
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- License
- C176768 (IA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
105 E Butler St
Manchester, IA 52057-1606
Phone: (563) 927-9400
Fax: (563) 927-6224
Approximate (ZIP-level) locationGet directions
Mailing address
715 Anderson St
Manchester, IA 52057-1401
Registry dates
- Enumerated
- 2023-10-17
- Last updated
- 2024-03-29
- Certified
- 2024-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.