Provider Demographics
NPI:1144903097
Name:LUNA MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:LUNA MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:515-468-3639
Mailing Address - Street 1:3086 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8021
Mailing Address - Country:US
Mailing Address - Phone:515-468-3639
Mailing Address - Fax:
Practice Address - Street 1:1200 VALLEY WEST DR STE 503
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1906
Practice Address - Country:US
Practice Address - Phone:515-468-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health