Provider Demographics
NPI:1699054817
Name:NEMMERS-BELLO, STEPHANIE RENAE (ARNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RENAE
Last Name:NEMMERS-BELLO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:R
Other - Last Name:NEMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1200 PLEASANT ST
Mailing Address - Street 2:POWELL 206
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1406
Mailing Address - Country:US
Mailing Address - Phone:515-241-5750
Mailing Address - Fax:515-241-5757
Practice Address - Street 1:1200 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1406
Practice Address - Country:US
Practice Address - Phone:515-241-5750
Practice Address - Fax:515-241-5757
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC-109537363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1699054817Medicaid
IAI22140013Medicare PIN