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General NPI Number Information
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NPI Number | 1932106044
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Entity Type | Individual
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Provider Name | TAMMY KAY COLEGROVE ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 1215 PLEASANT ST SUITE 506
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City | DES MOINES
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State | IA
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Zip | 50309-1416
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Country | US
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Telephone | 515-214-4044
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Fax | 515-241-4299
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Provider Business Mailing Address
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Address Line | 1215 PLEASANT ST SUITE 506
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City | DES MOINES
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State | IA
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Zip | 50309-1416
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Country | US
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Telephone | 515-241-4044
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Fax | 515-241-4142
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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 | A107489
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License Number State | IA
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