Healthcare Provider Details

I. General information

NPI: 1023924180
Provider Name (Legal Business Name): KATHRYN TERESA PHILLIPS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLEASANT ST STE 206
DES MOINES IA
50309-1419
US

IV. Provider business mailing address

PO BOX 424
DES MOINES IA
50302-0424
US

V. Phone/Fax

Practice location:
  • Phone: 515-875-9092
  • Fax:
Mailing address:
  • Phone: 515-875-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA193536
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: