Healthcare Provider Details

I. General information

NPI: 1407856651
Provider Name (Legal Business Name): MELISSA RADEMACHER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 48TH ST STE 260
WEST DES MOINES IA
50266-6726
US

IV. Provider business mailing address

5901 WESTOWN PKWY STE 210
WEST DES MOINES IA
50266-8297
US

V. Phone/Fax

Practice location:
  • Phone: 515-401-4774
  • Fax: 515-254-3092
Mailing address:
  • Phone: 515-221-9222
  • Fax: 515-221-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number109674
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR1357985
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: