NPI 1063758605 · live from the CMS NPI Registry
Blank Childrens Hospital
Nurse Practitioner, Pediatrics in Pleasant Hill, IA. National Provider Identifier 1063758605, active.
NPI record
| NPI | 1063758605 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 6540 Ne 12th Ave, Pleasant Hill, IA 50327 |
| Practice phone | 515-266-6795 |
| Mailing address | 1200 Pleasant St, Des Moines, IA 50309 |
| Enumerated | January 1, 2013 |
| Last updated | January 1, 2013 |
| Authorized official | Ken Cheyne, Physician |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | C-119097 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.