Provider Demographics
NPI:1881687408
Name:BRATKIEWICZ, K LINDA (DPM)
Entity Type:Individual
Prefix:DR
First Name:K
Middle Name:LINDA
Last Name:BRATKIEWICZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 115
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2364
Mailing Address - Country:US
Mailing Address - Phone:515-263-2474
Mailing Address - Fax:515-263-2478
Practice Address - Street 1:5950 UNIVERSITY AVE
Practice Address - Street 2:STE 160
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8216
Practice Address - Country:US
Practice Address - Phone:515-875-9876
Practice Address - Fax:515-875-9877
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00529213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU44641Medicare UPIN