Basic Information
Provider Information
NPI: 1114204641
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARWOSKI
FirstName: JESSICA
MiddleName: LEANN
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7147 VISTA DR STE 150
Address2:  
City: WEST DES MOINES
State: IA
PostalCode: 502669317
CountryCode: US
TelephoneNumber: 5158759925
FaxNumber: 5158759923
Practice Location
Address1: 1410 SW TRADITION DR STE 260
Address2:  
City: ANKENY
State: IA
PostalCode: 500239188
CountryCode: US
TelephoneNumber: 5158759290
FaxNumber: 5158759291
Other Information
ProviderEnumerationDate: 11/11/2011
LastUpdateDate: 10/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X111306NEN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
363L00000XF170666IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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