Healthcare Provider Details

I. General information

NPI: 1851150494
Provider Name (Legal Business Name): JAMIE KAY WERNER CRUM MSN, RN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SIOUX VALLEY DR
CHEROKEE IA
51012-1205
US

IV. Provider business mailing address

300 SIOUX VALLEY DR
CHEROKEE IA
51012-1205
US

V. Phone/Fax

Practice location:
  • Phone: 712-225-3368
  • Fax: 712-225-6866
Mailing address:
  • Phone: 712-225-3368
  • Fax: 712-225-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number122779
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: