Healthcare Provider Details

I. General information

NPI: 1083523864
Provider Name (Legal Business Name): DR. ANDREA HOLDEN MCGUIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 PARK AVE
DES MOINES IA
50315-2144
US

IV. Provider business mailing address

1914 PARK AVE
DES MOINES IA
50315-2144
US

V. Phone/Fax

Practice location:
  • Phone: 515-360-8709
  • Fax:
Mailing address:
  • Phone: 515-360-8709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number27615
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: