Healthcare Provider Details

I. General information

NPI: 1447142336
Provider Name (Legal Business Name): JENNIFER MARIE ELMORE MSN, ARNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 SW MAGAZINE RD
ANKENY IA
50023-2978
US

IV. Provider business mailing address

107 E 6TH AVE
SLATER IA
50244-9700
US

V. Phone/Fax

Practice location:
  • Phone: 515-348-6380
  • Fax: 515-452-0565
Mailing address:
  • Phone: 515-231-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG185714
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: