Provider Demographics
NPI:1568613214
Name:ENDERLIN, ANNE MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:ENDERLIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:LASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 675
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50303-0675
Mailing Address - Country:US
Mailing Address - Phone:515-471-9300
Mailing Address - Fax:515-471-9320
Practice Address - Street 1:6000 UNIVERSITY AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50366-8201
Practice Address - Country:US
Practice Address - Phone:515-241-2300
Practice Address - Fax:515-241-2305
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111896363LP0808X
IAG-111896363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health