Healthcare Provider Details

I. General information

NPI: 1326565045
Provider Name (Legal Business Name): ELISABETH ROSE LYONS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E ARMY POST RD
DES MOINES IA
50315-5939
US

IV. Provider business mailing address

1000 E ARMY POST RD
DES MOINES IA
50315-5939
US

V. Phone/Fax

Practice location:
  • Phone: 877-811-7526
  • Fax:
Mailing address:
  • Phone: 515-285-6200
  • Fax: 515-287-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF118964
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0197859
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number118964
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: