| Doctor Name: | CALLA L POLDBERG |
| NPI Number: | 1033303003 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | A077926 |
| Business Practice Address: | 1213 Garfield Ave Harlan, IA - 515372057 |
| Business Phone Number: | 7127554422 |
| Business Fax Number: | 7127554375 |
| Mailing Address: | 1213 Garfield Ave, HARLAN |
| State: | IA |
| Postal Code: | 515372057 |
| Phone Number: | 7127554422 |
| Fax Number: | 7127554375 |
| NPI Enumeration Date: | 08/31/2007 |
| NPI Last Update Date: | 10/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A077926 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |