Provider Demographics
NPI:1013261874
Name:DEPARTMENT OF VETERANS AFFAIRS CENTRAL IOWA HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS CENTRAL IOWA HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-779-4517
Mailing Address - Street 1:3011 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310
Mailing Address - Country:US
Mailing Address - Phone:515-779-4517
Mailing Address - Fax:
Practice Address - Street 1:3011 AURORA AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310
Practice Address - Country:US
Practice Address - Phone:515-779-4517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA128016282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital