Provider Demographics
NPI:1972546661
Name:VA CENTRAL IOWA
Entity Type:Organization
Organization Name:VA CENTRAL IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIDDINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:515-699-5999
Mailing Address - Street 1:1511 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-1625
Mailing Address - Country:US
Mailing Address - Phone:515-262-3628
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5876
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001672282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital