Provider Demographics
NPI:1619559481
Name:SUCKSTORF, WHITNEY LYNN (ARNP, CNM)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LYNN
Last Name:SUCKSTORF
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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:515-643-6869
Mailing Address - Fax:515-643-6899
Practice Address - Street 1:330 LAUREL ST STE 2300
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3068
Practice Address - Country:US
Practice Address - Phone:515-643-6869
Practice Address - Fax:515-643-6899
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB163038363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner