Healthcare Provider Details

I. General information

NPI: 1326972365
Provider Name (Legal Business Name): EMMANUEL O BEMPAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7105 NW 70TH AVE
JOHNSTON IA
50131-1824
US

IV. Provider business mailing address

185 S 87TH ST
WEST DES MOINES IA
50266-8320
US

V. Phone/Fax

Practice location:
  • Phone: 515-252-4910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberA189411
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: