Provider Demographics
NPI:1497576029
Name:KLEYWEGT, ALISSA (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:
Last Name:KLEYWEGT
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:
Practice Address - Street 1:842 NE ALICES RD
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8857
Practice Address - Country:US
Practice Address - Phone:515-875-9610
Practice Address - Fax:515-875-9611
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA181870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner