Provider Demographics
NPI:1437651692
Name:WALDSCHMIDT, BIANCA B (PA-C)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:B
Last Name:WALDSCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:B
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6000 UNIVERSITY AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8229
Mailing Address - Country:US
Mailing Address - Phone:515-241-2000
Mailing Address - Fax:515-241-2005
Practice Address - Street 1:6000 UNIVERSITY AVE STE 450
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8229
Practice Address - Country:US
Practice Address - Phone:515-241-2000
Practice Address - Fax:515-241-2005
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant