Nova Integrated Health, Pc | |
2675 N Ankeny Blvd Ste 113 Ankeny IA 50023-4719 | |
(515) 289-4549 | |
Not Available |
Full Name | Nova Integrated Health, Pc |
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Speciality | Clinic/Center |
Location | 2675 N Ankeny Blvd Ste 113, Ankeny, Iowa |
Authorized Official Name and Position | Taylor Vanden Wynboom (OWNER, CEO) |
Authorized Official Contact | 5152894549 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nova Integrated Health, Pc 1103 Ridgetop Dr Huxley IA 50124-4704 Ph: () - | Nova Integrated Health, Pc 2675 N Ankeny Blvd Ste 113 Ankeny IA 50023-4719 Ph: (515) 289-4549 |
NPI Number | 1417412750 |
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Provider Enumeration Date | 01/31/2019 |
Last Update Date | 01/31/2019 |
Medicare PECOS PAC ID | 9436498391 |
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Medicare Enrollment ID | O20190312000470 |
Identifier | Type | State | Issuer |
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1417412750 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Amanda J Vanden Wynboom |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902321110 PECOS PAC ID: 6507105467 Enrollment ID: I20190312000569 |
Provider Name | Lindsay P Maxwell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790322584 PECOS PAC ID: 1052747177 Enrollment ID: I20200210001972 |
Provider Name | Jenica Dunavan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114549847 PECOS PAC ID: 9638599632 Enrollment ID: I20201013001571 |
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