Healthcare Provider Details

I. General information

NPI: 1366247793
Provider Name (Legal Business Name): ASHTON LENEE BUCK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ASHTON LENEE AULT

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST STE A120
DES MOINES IA
50314-3027
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-7900
  • Fax: 515-643-7901
Mailing address:
  • Phone: 515-643-7900
  • Fax: 515-643-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberH180502
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: