Healthcare Provider Details

I. General information

NPI: 1982919817
Provider Name (Legal Business Name): SUSAN LATHROP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLEASANT ST BLANK CHILDREN'S HOSPITAL
DES MOINES IA
50309-1416
US

IV. Provider business mailing address

1215 PLEASANT ST BLANK CHILDREN'S HOSPITAL
DES MOINES IA
50309-1416
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6137
  • Fax: 515-241-8911
Mailing address:
  • Phone: 515-241-6137
  • Fax: 515-241-8911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number061794
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: