Healthcare Provider Details

I. General information

NPI: 1124797212
Provider Name (Legal Business Name): DANIELLE FITCH DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 19TH ST
DES MOINES IA
50314-1112
US

IV. Provider business mailing address

5417 SE 28TH CT
DES MOINES IA
50320-2038
US

V. Phone/Fax

Practice location:
  • Phone: 515-605-0704
  • Fax: 515-644-5503
Mailing address:
  • Phone: 515-943-9695
  • Fax: 515-644-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG165507
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: