Individual
KILEY OTTERVANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6000 UNIVERSITY AVE STE 100, WEST DES MOINES, IA 50266-8200
(515) 241-2500
Mailing address
6000 UNIVERSITY AVE STE 100, WEST DES MOINES, IA 50266-8200
(515) 241-2500
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO-04638
IA
208000000X
Pediatrics Physician
R-9571
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942564745
—
IA
Enumeration date
06/27/2012
Last updated
03/26/2015
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