1740005685 NPI number — MRS. DESIREE ANN BASMAYOR TELERON-WALHOVD MSN,FNP-C

Table of content: KATIE LYN STONE PT, DPT (NPI 1356854046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740005685 NPI number — MRS. DESIREE ANN BASMAYOR TELERON-WALHOVD MSN,FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TELERON-WALHOVD
Provider First Name:
DESIREE ANN
Provider Middle Name:
BASMAYOR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN,FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740005685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 PLEASANT ST STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50309-1426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-241-4200
Provider Business Mailing Address Fax Number:
515-241-4081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1221 PLEASANT ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50309-1426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-241-4200
Provider Business Practice Location Address Fax Number:
515-241-4081
Provider Enumeration Date:
11/16/2024

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: 363L00000X , with the licence number:  A182238 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: 165490 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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