Provider Demographics
NPI:1336424795
Name:RICH, DANA ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ELIZABETH
Last Name:RICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:ELIZABETH
Other - Last Name:LEININGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4925
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-4925
Mailing Address - Country:US
Mailing Address - Phone:515-643-5100
Mailing Address - Fax:515-643-5150
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 3262
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-643-5100
Practice Address - Fax:515-643-5150
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA112053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily