Healthcare Provider Details

I. General information

NPI: 1639431430
Provider Name (Legal Business Name): REBECCA LYNN ROVNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 WOODLAND AVE SUITE 140
DES MOINES IA
50309-3203
US

IV. Provider business mailing address

1415 WOODLAND AVE SUITE 140
DES MOINES IA
50309-3203
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-5995
  • Fax: 515-241-6576
Mailing address:
  • Phone: 515-241-5995
  • Fax: 515-241-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number43437
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number43437
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: