Healthcare Provider Details

I. General information

NPI: 1639844889
Provider Name (Legal Business Name): ANGELA PEMBROKE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SW 7TH ST STE A
DES MOINES IA
50309-4538
US

IV. Provider business mailing address

501 SW 7TH ST STE A
DES MOINES IA
50309-4538
US

V. Phone/Fax

Practice location:
  • Phone: 515-304-5505
  • Fax: 833-972-5580
Mailing address:
  • Phone: 515-304-5505
  • Fax: 833-972-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA164687
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: