Provider Demographics
NPI:1881980167
Name:JENNINGS, SUNSHINE MCDANIEL (ARNP)
Entity type:Individual
Prefix:
First Name:SUNSHINE
Middle Name:MCDANIEL
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:SUNSHINE
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9317
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:1410 SW TRADITION DR STE 150
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9188
Practice Address - Country:US
Practice Address - Phone:515-875-9980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN180153363L00000X
IAH141272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003110993AMedicaid
GA003110993AMedicaid