Provider Demographics
NPI:1053126110
Name:WILLOW TREE HOLISTIC HEALTH
Entity type:Organization
Organization Name:WILLOW TREE HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP, PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:WITBECK
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:563-260-7223
Mailing Address - Street 1:450 HIGHWAY 1 W STE 176
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4204
Mailing Address - Country:US
Mailing Address - Phone:319-281-0290
Mailing Address - Fax:319-500-4642
Practice Address - Street 1:2927 IWV ROAD SW
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246
Practice Address - Country:US
Practice Address - Phone:319-281-0290
Practice Address - Fax:319-500-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty