Healthcare Provider Details

I. General information

NPI: 1043165343
Provider Name (Legal Business Name): JORDAN SNOOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E UNIVERSITY AVE
DES MOINES IA
50316-2302
US

IV. Provider business mailing address

908 W ASPEN RIDGE CIR
POLK CITY IA
50226-2294
US

V. Phone/Fax

Practice location:
  • Phone: 515-263-2444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG189875
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number150980
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: