MEDICARE: MARY HUESMANN APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209.006260	IL
2	363LF0000X	Family Nurse Practitioner	A105868	IA

General Provider Information

NPI Number	:	1275792566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY HUESMANN APN

Provider Business Mailing Address
First Line	:	1776 W LAKES PKWY STE 400
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8378
Country	:	US
Telephone Number	:	515-241-6161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1776 W LAKES PKWY STE 400
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8378
Country	:	US
Telephone Number	:	515-241-6161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	02/15/2024

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Directions to “ MARY HUESMANN APN” Practice Location

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