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General NPI Number Information
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NPI Number | 1457681835
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Entity Type | Individual
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Provider Name | MARIA ASTRA FELECIA FECUNDO ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2010
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 411 LAUREL ST STE 2350
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City | DES MOINES
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State | IA
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Zip | 50314-3026
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Country | US
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Telephone | 515-280-4700
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Fax | 515-280-4701
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Provider Business Mailing Address
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Address Line | 411 LAUREL ST STE 2350
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City | DES MOINES
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State | IA
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Zip | 50314-3026
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Country | US
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Telephone | 515-280-4700
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Fax | 515-280-4701
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | H161918
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.360387
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License Number State | IL
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