Healthcare Provider Details

I. General information

NPI: 1083248256
Provider Name (Legal Business Name): ERIN LYNNE KILGORE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN LYNNE REWERTS ARNP

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 SW STATE ST STE 100
ANKENY IA
50023-7079
US

IV. Provider business mailing address

5905 NE GRANT CT
ANKENY IA
50021-1231
US

V. Phone/Fax

Practice location:
  • Phone: 515-964-6929
  • Fax: 515-964-6930
Mailing address:
  • Phone: 515-350-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA158112
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: