Provider Demographics
NPI:1942562020
Name:RUNKEL, ANGELA MARIA (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:RUNKEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 POLK BLVD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2334
Mailing Address - Country:US
Mailing Address - Phone:515-490-1545
Mailing Address - Fax:
Practice Address - Street 1:1201 PENN AVENUE
Practice Address - Street 2:PENN AVENUE INTERNAL MEDICINE
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316
Practice Address - Country:US
Practice Address - Phone:515-471-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-080089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily