Healthcare Provider Details

I. General information

NPI: 1639141641
Provider Name (Legal Business Name): JENNIFER L SWEARINGEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER L KELLEHER

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 2ND AVE STE 201B
CORALVILLE IA
52241-2225
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-2000
  • Fax: 319-467-2815
Mailing address:
  • Phone: 319-467-2000
  • Fax: 319-467-2815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number083537
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA083537
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: