Dewilde, Jason T

Dewilde, Jason T is an individual health care provider with primary practice located at 5901 Westown Pkwy Suite 210, West Des Moines IA 50266-8218. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Dewilde, Jason T can be contacted via phone (515) 221-9222.

Contact Information

Primary practice address
5901 Westown Pkwy Suite 210 West Des Moines IA 50266-8218
Phone: (515) 221-9222
Fax: (515) 221-0575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X DO53141 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X D-097433 Iowa

Profile Details

NPI number 1982696043
LBN Legal business name Dewilde, Jason T
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jun 29th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982696043 NPPES
Iowa Other 50171 GROUP MEDICARE NUMBER
Iowa MEDICAID 0285411 GROUP MEDICARE NUMBER
Iowa Other 50171 GROUP MEDICARE NUMBER

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