MEDICARE: DR. KELLIE K BEMENT DNP, ARNP

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	163W00000X	Registered Nurse	104780	IA
2	363LF0000X	Family Nurse Practitioner	A104780	IA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G176775	IA

General Provider Information

NPI Number	:	1487170718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLIE K BEMENT DNP, ARNP

Provider Business Mailing Address
First Line	:	6750 WESTOWN PARKWAY #200
Second Line	:	BOX 134
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266
Country	:	US
Telephone Number	:	515-558-6865
Fax Number	:	949-703-8835

Provider Business Practice Location Address
First Line	:	4401 WESTOWN PKWY STE 108
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-6721
Country	:	US
Telephone Number	:	515-493-6595
Fax Number	:

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

Provider Enumeration Date	:	08/18/2017
Last Update Date	:	01/21/2026

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