Provider Demographics
NPI:1356034532
Name:PILIPOVIC, MALKAN (ARNP)
Entity type:Individual
Prefix:
First Name:MALKAN
Middle Name:
Last Name:PILIPOVIC
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:IA
Mailing Address - Zip Code:50061-8501
Mailing Address - Country:US
Mailing Address - Phone:515-210-1488
Mailing Address - Fax:
Practice Address - Street 1:2500 82ND PL
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4329
Practice Address - Country:US
Practice Address - Phone:515-412-5112
Practice Address - Fax:515-412-5123
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG174357363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health