Provider Demographics
NPI:1689409872
Name:ONDUSO, ROSEMARY KEMUNTO (APRN, CNM)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:KEMUNTO
Last Name:ONDUSO
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-2294
Mailing Address - Fax:319-384-7346
Practice Address - Street 1:1360 N DODGE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-6114
Practice Address - Country:US
Practice Address - Phone:319-356-2294
Practice Address - Fax:319-384-9693
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB181055176B00000X
IACNM09551367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife