MEDICARE: MS. JOAN MARIE JULSETH-LEWIS 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	363L00000X	Nurse Practitioner	098303	IA
2	363LA2200X	Adult Health Nurse Practitioner	098303	IA

General Provider Information

NPI Number	:	1972590479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN MARIE JULSETH-LEWIS ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-247-4240
Fax Number	:	515-247-4239

Provider Business Practice Location Address
First Line	:	1111 6TH AVE
Second Line	:	4 SOUTH
City	:	DES MOINES
State	:	IA
Zip	:	50314-2613
Country	:	US
Telephone Number	:	515-247-4240
Fax Number	:	515-247-4239

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	03/29/2017

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