Healthcare Provider Details
I. General information
NPI: 1548078355
Provider Name (Legal Business Name): EMILY VORE MSN, RN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 PLEASANT ST YOUNKER 123
DES MOINES IA
50309
US
IV. Provider business mailing address
1288 PRAIRIE DR
STORY CITY IA
50248-1843
US
V. Phone/Fax
- Phone: 515-241-5567
- Fax:
- Phone: 608-769-2660
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 164529 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SM0705X |
| Taxonomy | Medical-Surgical Clinical Nurse Specialist |
| License Number | 2021051018 |
| License Number State | IA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | W181730 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: