Provider Demographics
NPI:1790300648
Name:KDP MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:KDP MANAGEMENT SERVICES LLC
Other - Org Name:INTEGRATIVE FAMILY MEDICINE OF IOWA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBELIS POHREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-226-3415
Mailing Address - Street 1:475 S 50TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-6979
Mailing Address - Country:US
Mailing Address - Phone:515-226-3415
Mailing Address - Fax:870-252-2681
Practice Address - Street 1:475 S 50TH ST STE 600
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-6979
Practice Address - Country:US
Practice Address - Phone:319-531-6000
Practice Address - Fax:870-252-2681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
363L00000XOtherTAXONOMY