Healthcare Provider Details

I. General information

NPI: 1114521721
Provider Name (Legal Business Name): TARRAH L HOLLIDAY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 MERLE HAY RD. STE 204
DES MOINES IA
50322
US

IV. Provider business mailing address

4725 MERLE HAY RD STE 204
DES MOINES IA
50322-1983
US

V. Phone/Fax

Practice location:
  • Phone: 515-461-8889
  • Fax: 515-809-3668
Mailing address:
  • Phone: 515-461-8889
  • Fax: 515-809-3668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number137905
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: