Provider Demographics
NPI:1326090366
Name:VANCE, BEN G (PA)
Entity Type:Individual
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First Name:BEN
Middle Name:G
Last Name:VANCE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9313
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5950 UNIVERSITY AVE STE 105
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-875-9070
Practice Address - Fax:515-875-9071
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-08-17
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Provider Licenses
StateLicense IDTaxonomies
IA002179363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39352OtherBCBS
NE39352OtherBCBS