Provider Demographics
NPI:1285660050
Name:BOOTH, JENNIFER RENEA (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEA
Last Name:BOOTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4949 WESTOWN PARKWAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6716
Mailing Address - Country:US
Mailing Address - Phone:515-223-5466
Mailing Address - Fax:515-223-5405
Practice Address - Street 1:4949 WESTOWN PARKWAY
Practice Address - Street 2:SUITE 140
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6716
Practice Address - Country:US
Practice Address - Phone:515-223-5466
Practice Address - Fax:515-223-5405
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA37040208M00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist