Provider Demographics
NPI:1023095163
Name:WHEELER, DENISE G (ARNP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:G
Last Name:WHEELER
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 1:1105 N ANKENY BLVD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4006
Mailing Address - Country:US
Mailing Address - Phone:515-964-4600
Mailing Address - Fax:515-963-9516
Practice Address - Street 1:1105 N ANKENY BLVD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4006
Practice Address - Country:US
Practice Address - Phone:515-964-4600
Practice Address - Fax:515-963-9516
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB052567363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1141697Medicaid
S28524Medicare UPIN
I6277Medicare PIN