Healthcare Provider Details

I. General information

NPI: 1245855758
Provider Name (Legal Business Name): JENIFER RUTH DEUTMEYER MCGOVERN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 JOHNSON ST SW
CASCADE IA
52033-8636
US

IV. Provider business mailing address

2939 197TH ST
EARLVILLE IA
52041-8603
US

V. Phone/Fax

Practice location:
  • Phone: 563-852-7757
  • Fax: 563-852-7758
Mailing address:
  • Phone: 563-845-1508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20225
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: