Provider Demographics
NPI:1871571414
Name:KIENKER, KAREN A (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:KIENKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1221 PLEASANT ST
Mailing Address - Street 2:SUITE 375
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1423
Mailing Address - Country:US
Mailing Address - Phone:515-241-4646
Mailing Address - Fax:515-241-4009
Practice Address - Street 1:1221 PLEASANT ST
Practice Address - Street 2:SUITE 375
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1423
Practice Address - Country:US
Practice Address - Phone:515-241-4646
Practice Address - Fax:515-241-4009
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2012-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA24649208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1871571414Medicaid
IA250012915OtherRR MEDICARE
IA3027557Medicaid
IA3027557Medicaid
IAA03906Medicare UPIN