Healthcare Provider Details

I. General information

NPI: 1417878372
Provider Name (Legal Business Name): LISA MARIE BRYANT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E COURT AVE STE 200
DES MOINES IA
50309-2044
US

IV. Provider business mailing address

12504 HORTON AVE
URBANDALE IA
50323-2328
US

V. Phone/Fax

Practice location:
  • Phone: 515-282-2921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA192839
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA192839
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: