Healthcare Provider Details

I. General information

NPI: 1558044412
Provider Name (Legal Business Name): ALEXIA MARIE CHALLY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLEASANT ST STE 303
DES MOINES IA
50309-1422
US

IV. Provider business mailing address

1502 RED CEDAR LN
GRANGER IA
50109-4732
US

V. Phone/Fax

Practice location:
  • Phone: 319-929-8306
  • Fax: 515-241-6533
Mailing address:
  • Phone: 319-929-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number153544
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number153544
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: