Individual
LISA WEATHERWAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP, PMHNP-BC
Contact information
Practice address
5000 WESTOWN PKWY STE 104, WEST DES MOINES, IA 50266-5936
(515) 679-3947
(515) 349-5301
Mailing address
5000 WESTOWN PKWY STE 104, WEST DES MOINES, IA 50266-5936
(515) 679-3947
(515) 349-5301
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G175623
IA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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