Provider Demographics
NPI:1326413519
Name:GALLION, KIMBERLY (ARNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:GALLION
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 5TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1307
Mailing Address - Country:US
Mailing Address - Phone:515-235-0462
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:2530 CHAMBERLAIN ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7272
Practice Address - Country:US
Practice Address - Phone:515-292-1000
Practice Address - Fax:515-292-5340
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB142504367A00000X
NE73667163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse