Healthcare Provider Details

I. General information

NPI: 1366516627
Provider Name (Legal Business Name): ASSOCIATES IN KIDNEY CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE STE 510
DES MOINES IA
50314-2610
US

IV. Provider business mailing address

1111 6TH AVE STE 510
DES MOINES IA
50314-2610
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-5275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number01563
License Number StateIA

VIII. Authorized Official

Name: NANCY NUNN
Title or Position: OFFICE MANAGER
Credential:
Phone: 515-643-5275