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General NPI Number Information
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NPI Number | 1437751567
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Entity Type | Organization
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Legal Business Name | GREENWOOD MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 500 N VALLEY DR UNIT 804
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City | DES MOINES
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State | IA
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Zip | 50312-1625
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Country | US
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Telephone | 515-480-7987
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N VALLEY DR UNIT 804
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City | DES MOINES
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State | IA
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Zip | 50312-1625
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Country | US
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Telephone | 515-480-7987
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | FRED JAMES NESBIT III
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Credential | ARNP
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Telephone | 515-480-7987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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