Individual
KATHLEEN S DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1200 PLEASANT ST, SUITE 206, DES MOINES, IA 50309-1406
(515) 241-5750
(515) 241-5757
Mailing address
1200 PLEASANT ST, SUITE 206, DES MOINES, IA 50309-1406
(515) 241-5750
(515) 241-5757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A076050
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578755732
—
IA
01
—
P01041571
RR MEDICARE
IA
Enumeration date
08/13/2007
Last updated
10/30/2012
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