Healthcare Provider Details

I. General information

NPI: 1508649153
Provider Name (Legal Business Name): BROOKE ALEXIS JORDAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 UNIVERSITY AVE STE 151
WEST DES MOINES IA
50266-8234
US

IV. Provider business mailing address

7147 VISTA DR STE 150
WEST DES MOINES IA
50266-9317
US

V. Phone/Fax

Practice location:
  • Phone: 515-875-9000
  • Fax:
Mailing address:
  • Phone: 515-875-9923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA175915
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: