Healthcare Provider Details

I. General information

NPI: 1831691799
Provider Name (Legal Business Name): KIMBERLY ANN SKIPWORTH DO STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 WESTOWN PKWY STE 140
WEST DES MOINES IA
50266-6716
US

IV. Provider business mailing address

4949 WESTOWN PKWY STE 140
WEST DES MOINES IA
50266-6716
US

V. Phone/Fax

Practice location:
  • Phone: 515-223-5466
  • Fax: 515-223-5405
Mailing address:
  • Phone: 515-223-5466
  • Fax: 515-223-5405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number06025
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: