Healthcare Provider Details
I. General information
NPI: 1851150494
Provider Name (Legal Business Name): JAMIE KAY WERNER CRUM FNP-BC, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/18/2024
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
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
- Phone: 712-225-3368
- Fax: 712-225-6866
- Phone: 712-225-3368
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A191406 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | 122779 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: