Provider Demographics
NPI:1578803235
Name:KINNETZ, MEGHAN MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:MARIE
Last Name:KINNETZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-358-0011
Mailing Address - Fax:515-358-0099
Practice Address - Street 1:1111 6TH AVE
Practice Address - Street 2:SUITE A100
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2613
Practice Address - Country:US
Practice Address - Phone:515-358-0011
Practice Address - Fax:515-358-0099
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAA114587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily