Healthcare Provider Details
I. General information
NPI: 1518194000
Provider Name (Legal Business Name): LINDSEY JANE KOELE-SCHMIDT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2009
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 PLEASANT ST
DES MOINES IA
50309-1406
US
IV. Provider business mailing address
1200 PLEASANT ST
DES MOINES IA
50309-1406
US
V. Phone/Fax
- Phone: 515-241-5926
- Fax: 515-241-5127
- Phone: 515-241-5926
- Fax: 515-241-5127
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD-42632 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | MD-42632 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: