Provider Demographics
NPI:1780769323
Name:ANDERSON, AARON LEE (PA-C)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:515-282-2921
Mailing Address - Fax:515-282-1035
Practice Address - Street 1:1221 PLEASANT STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:515-282-2921
Practice Address - Fax:515-282-1035
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001750363A00000X
IA0001750IA364SX0200X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00445299OtherRR MEDICARE
IAI19126Medicare PIN