Healthcare Provider Details

I. General information

NPI: 1396732723
Provider Name (Legal Business Name): KATHERINE KERRIE HIPPLER O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 HICKMAN RD
DES MOINES IA
50314-1597
US

IV. Provider business mailing address

1801 HICKMAN RD
DES MOINES IA
50314-1597
US

V. Phone/Fax

Practice location:
  • Phone: 515-282-5621
  • Fax: 515-282-3618
Mailing address:
  • Phone: 515-282-5621
  • Fax: 515-282-3618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number00719
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number00719
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: