Provider Demographics
NPI:1740005685
Name:TELERON-WALHOVD, DESIREE ANN BASMAYOR (MSN,FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DESIREE ANN
Middle Name:BASMAYOR
Last Name:TELERON-WALHOVD
Suffix:
Gender:F
Credentials:MSN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SAINT MARYS CT
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:IA
Mailing Address - Zip Code:50250-8601
Mailing Address - Country:US
Mailing Address - Phone:515-802-6600
Mailing Address - Fax:
Practice Address - Street 1:1204 LINDEN ST
Practice Address - Street 2:
Practice Address - City:DALLAS CENTER
Practice Address - State:IA
Practice Address - Zip Code:50063-1052
Practice Address - Country:US
Practice Address - Phone:515-992-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA182238363LF0000X
IA165490163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily