Healthcare Provider Details

I. General information

NPI: 1881512291
Provider Name (Legal Business Name): JENNIFER PHIPPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 UNIVERSITY AVE STE 212
WEST DES MOINES IA
50266-1462
US

IV. Provider business mailing address

2600 UNIVERSITY AVE STE 212
WEST DES MOINES IA
50266-1462
US

V. Phone/Fax

Practice location:
  • Phone: 515-259-0662
  • Fax:
Mailing address:
  • Phone: 515-259-0662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number004855
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: