1790969715 NPI number — CARISSA L SCHEVE ARNP

Table of content: CARISSA L SCHEVE ARNP (NPI 1790969715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790969715 NPI number — CARISSA L SCHEVE ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEVE
Provider First Name:
CARISSA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VERHEY
Provider Other First Name:
CARISSA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790969715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1212 PLEASANT STREET
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50309-1453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-241-6000
Provider Business Mailing Address Fax Number:
515-241-8728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 PLEASANT STREET
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50309-1453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-241-6000
Provider Business Practice Location Address Fax Number:
515-241-8728
Provider Enumeration Date:
12/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  C108446 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1790969715 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1790969715 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 175150092 . This is a "MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com