Healthcare Provider Details

I. General information

NPI: 1265111991
Provider Name (Legal Business Name): DANIELLE JARNAGIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 11/11/2023
Certification Date: 11/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

8308 PLUM DR
URBANDALE IA
50322-1000
US

V. Phone/Fax

Practice location:
  • Phone: 515-554-2947
  • Fax:
Mailing address:
  • Phone: 515-554-2947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH174279
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberH174279
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: