Provider Demographics
NPI:1427164896
Name:ARISPE, CONNIE J (MD)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:J
Last Name:ARISPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:IA
Mailing Address - Zip Code:50438-1242
Mailing Address - Country:US
Mailing Address - Phone:641-923-2651
Mailing Address - Fax:641-923-2652
Practice Address - Street 1:730 W 3RD ST
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:IA
Practice Address - Zip Code:50438-1242
Practice Address - Country:US
Practice Address - Phone:641-923-2651
Practice Address - Fax:641-923-2652
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2091546Medicaid
IA16997OtherWELLMARK
IA2091546Medicaid
IAF30956Medicare UPIN