Healthcare Provider Details

I. General information

NPI: 1629844485
Provider Name (Legal Business Name): JEFFREY JAMES SHYMANSKI AU.D., CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 N ANKENY BLVD STE 103
ANKENY IA
50023-4619
US

IV. Provider business mailing address

3720 N ANKENY BLVD STE 103
ANKENY IA
50023-4619
US

V. Phone/Fax

Practice location:
  • Phone: 515-499-8622
  • Fax:
Mailing address:
  • Phone: 515-499-8622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number123257
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number123380
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: