Healthcare Provider Details

I. General information

NPI: 1417297326
Provider Name (Legal Business Name): MERCY CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 UNIVERSITY AVE SUITE 200
DES MOINES IA
50314-2343
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-8672
  • Fax:
Mailing address:
  • Phone: 515-643-8672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID H VELLINGA
Title or Position: PRES/CEO
Credential:
Phone: 515-247-4278