MEDICARE: LINDA DEE REAM L.I.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	00717	IA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G132903	IA

General Provider Information

NPI Number	:	1255333894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA DEE REAM L.I.S.W.

Provider Business Mailing Address
First Line	:	3900 INGERSOLL AVE
Second Line	:	SUITE 108
City	:	DES MOINES
State	:	IA
Zip	:	50312-3534
Country	:	US
Telephone Number	:	515-279-6200
Fax Number	:	515-279-4528

Provider Business Practice Location Address
First Line	:	3900 INGERSOLL AVE
Second Line	:	SUITE 108
City	:	DES MOINES
State	:	IA
Zip	:	50312-3534
Country	:	US
Telephone Number	:	515-279-6200
Fax Number	:	515-279-4528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	09/22/2017

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Directions to “ LINDA DEE REAM L.I.S.W.” Practice Location

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