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General NPI Number Information
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NPI Number | 1720945215
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Entity Type | Individual
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Provider Name | MRS. KEELEY JAHANSOUZ
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 3200 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-4104
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Country | US
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Telephone | 515-271-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 S RADLEY ST
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City | WEST DES MOINES
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State | IA
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Zip | 50266-6783
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Country | US
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Telephone | 573-355-4971
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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