Provider Demographics
NPI:1992069629
Name:IRLMEIER, LINDSEY R
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:R
Last Name:IRLMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N ANKENY BLVD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1753
Mailing Address - Country:US
Mailing Address - Phone:515-964-1601
Mailing Address - Fax:515-964-1608
Practice Address - Street 1:410 N ANKENY BLVD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1753
Practice Address - Country:US
Practice Address - Phone:515-964-1601
Practice Address - Fax:515-964-1608
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-121399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1992069629Medicaid
IA719260508Medicare PIN