Provider Demographics
NPI:1811960768
Name:VEENSTRA, ANGELA J (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:VEENSTRA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 OFFICE PARK RD STE 317
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2509
Mailing Address - Country:US
Mailing Address - Phone:515-957-1190
Mailing Address - Fax:515-957-7950
Practice Address - Street 1:1001 OFFICE PARK RD STE 317
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2509
Practice Address - Country:US
Practice Address - Phone:515-957-1190
Practice Address - Fax:515-957-7950
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2022066633363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA13074OtherWELLMARK
IA2419333Medicaid
IA0419333Medicaid
IAIA0127OtherJOHN DEERE PROVIDER NUMBE
IA1419333Medicaid
IA13126OtherWELLMARK
IAIA0127OtherJOHN DEERE PROVIDER NUMBE
IA13074OtherWELLMARK