Healthcare Provider Details

I. General information

NPI: 1316341969
Provider Name (Legal Business Name): JENNIFER A SPENDLOVE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2014
Last Update Date: 10/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 WESTOWN PKWY SUITE 1101
WEST DES MOINES IA
50266-1427
US

IV. Provider business mailing address

2501 WESTOWN PKWY SUITE 1101
WEST DES MOINES IA
50266-1427
US

V. Phone/Fax

Practice location:
  • Phone: 515-267-8300
  • Fax: 515-267-8872
Mailing address:
  • Phone: 515-267-8300
  • Fax: 515-267-8872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number138230
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: