Healthcare Provider Details
I. General information
NPI: 1992314108
Provider Name (Legal Business Name): LYNZEE MAKOWSKI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2020
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 PLEASANT ST
DES MOINES IA
50309-1453
US
IV. Provider business mailing address
28209 530TH AVE
KELLEY IA
50134-8550
US
V. Phone/Fax
- Phone: 515-241-5031
- Fax:
- Phone: 651-329-7994
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | A157012 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | A157012 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: