Individual
AMANDA COLLICOTT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
Mailing address
5104 70TH ST, URBANDALE, IA 50322-6912
(515) 822-2694
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A114412
IA
363LP0200X
Pediatric Nurse Practitioner
A114412
IA
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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