Healthcare Provider Details

I. General information

NPI: 1124315197
Provider Name (Legal Business Name): TASHA BEENKEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
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 TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number4716
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4716
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: