Individual
MR. EDMUND J PIASECKI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1111 6TH AVE, MERCY MEDICAL CENTE ER, DES MOINES, IA 50314-2610
(515) 247-3173
Mailing address
2207 WILLOWMERE DR, DES MOINES, IA 50321-1539
(515) 244-4550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2001021075
MO
363LF0000X
Family Nurse Practitioner
45213
KS
363LF0000X
Family Nurse Practitioner
Primary
A100182
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463448
—
IA
05
—
425701505
—
MO
05
—
425701513
—
MO
Enumeration date
11/08/2005
Last updated
01/30/2012
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