=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992398341
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARI LYNN POLLITT ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2021
-----------------------------------------------------
Last Update Date | 02/17/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 30TH ST
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50310-5753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-699-5521
-----------------------------------------------------
Fax | 515-699-5669
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 53900 280TH AVE
-----------------------------------------------------
City | CHARITON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50049-8126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-203-4994
-----------------------------------------------------
Fax | 515-699-5669
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | G162092
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------