Healthcare Provider Details

I. General information

NPI: 1689497141
Provider Name (Legal Business Name): RESTORE HEALTH COLLABORATIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 E 2ND ST
PELLA IA
50219-1200
US

IV. Provider business mailing address

1119 E 2ND ST
PELLA IA
50219-1200
US

V. Phone/Fax

Practice location:
  • Phone: 641-619-5154
  • Fax:
Mailing address:
  • Phone: 641-619-5154
  • Fax: 641-230-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARITY CARSTENSEN
Title or Position: OWNER
Credential: ARNP
Phone: 641-619-5154