Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | MD442079 | PA |
Y | 2086S0102X | Surgical Critical Care | MD45158 | IA |
NPI | 1245216720 |
---|---|
Provider Name | Jeannette M Capella |
First Address | West Des Moines, IA 50266-9313 |
Second Address | Des Moines, IA 50309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 17/08/2021 |