Piasecki Iii, Edmund J
Piasecki Iii, Edmund J is an individual health care provider with primary practice located at 1111 6Th Ave Mercy Medical Cente Er, Des Moines IA 50314-2610. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Piasecki Iii, Edmund J can be contacted via phone (515) 247-3173.Contact Information
Primary practice address
1111 6Th Ave Mercy Medical Cente Er
Des Moines IA 50314-2610
Phone: (515) 247-3173
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A100182 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2001021075 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 45213 | Kansas |
Profile Details
| NPI number | 1477534279 |
|---|---|
| LBN Legal business name | Piasecki Iii, Edmund J |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2005 |
| Last updated | Jan 30th, 2012 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477534279 | NPPES |
| Missouri | MEDICAID | 425701513 | |
| Missouri | MEDICAID | 0463448 | |
| Missouri | MEDICAID | 425701505 |
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