Provider Demographics
NPI:1518956333
Name:PEARL, KRISTA DAVIS (MSN, ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:DAVIS
Last Name:PEARL
Suffix:
Gender:F
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 WESTOWN PKWY STE 140
Mailing Address - Street 2:
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 PKWY, SUITE 140
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6717
Practice Address - Country:US
Practice Address - Phone:515-223-5466
Practice Address - Fax:515-223-5405
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-111371363LF0000X
IAF111371363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily