Individual
COURT ADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3301 AMHERST ST, DES MOINES, IA 50313-4608
(515) 770-1827
Mailing address
3301 AMHERST ST, DES MOINES, IA 50313-4608
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P45850
IA
Other
Enumeration date
11/17/2012
Last updated
11/17/2012
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