Provider Demographics
NPI:1639189293
Name:ZEA, ERIN (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ZEA
Suffix:
Gender:F
Credentials:ARNP
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:515-643-7100
Mailing Address - Fax:515-643-7145
Practice Address - Street 1:2605 SW WHITE BIRCH DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7204
Practice Address - Country:US
Practice Address - Phone:515-643-7100
Practice Address - Fax:515-643-7145
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO96684363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP15626Medicare UPIN
IA0422659Medicaid
IAI3972Medicare ID - Type Unspecified