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General NPI Number Information
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NPI Number | 1154190643
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Entity Type | Individual
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Provider Name | ANTHONY KINLEY
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Gender | Male
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 5901 THORNTON AVE STE 101
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City | DES MOINES
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State | IA
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Zip | 50321-2422
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Country | US
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Telephone | 515-327-2000
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Fax | 515-327-2019
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Provider Business Mailing Address
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Address Line | 1316 S MAIN ST
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City | CLARION
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State | IA
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Zip | 50525-2019
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Country | US
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Telephone | 844-474-4321
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Fax | 319-343-1161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 123865
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License Number State | IA
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