MEDICARE: ELIZABETH ANN KRIENER PA-C

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	363A00000X	Physician Assistant	832	IA

General Provider Information

NPI Number	:	1598857112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN KRIENER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-989-3221
Fax Number	:	515-989-4518

Provider Business Practice Location Address
First Line	:	125 SCHOOL ST
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-8702
Country	:	US
Telephone Number	:	515-989-3221
Fax Number	:	515-989-4518

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	09/19/2014

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