Healthcare Provider Details

I. General information

NPI: 1679761431
Provider Name (Legal Business Name): CASSIE J LIMOGES PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5406 MERLE HAY RD.
JOHNSTON IA
50131-1209
US

IV. Provider business mailing address

5406 MERLE HAY ROAD PO BOX 707
JOHNSTON IA
50131
US

V. Phone/Fax

Practice location:
  • Phone: 515-727-8750
  • Fax: 515-727-8757
Mailing address:
  • Phone: 515-727-8750
  • Fax: 515-727-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberC165789
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP2912
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberC165789
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberAP4367
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number2243
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberC165789
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: