Provider Demographics
NPI:1730150665
Name:MEYER, JENNIFER (ARNP FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:ARNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-3433
Mailing Address - Country:US
Mailing Address - Phone:563-262-4111
Mailing Address - Fax:563-264-9175
Practice Address - Street 1:1518 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3433
Practice Address - Country:US
Practice Address - Phone:563-262-4111
Practice Address - Fax:563-264-9175
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA079584363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0481135Medicaid
IAI17037Medicare PIN
IAQ64358Medicare UPIN