Healthcare Provider Details

I. General information

NPI: 1366015547
Provider Name (Legal Business Name): JILL E BARTLETT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 PLEASANT ST STE 1
DES MOINES IA
50314-1728
US

IV. Provider business mailing address

1263 NORTHRIDGE RD
STORY CITY IA
50248-9505
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-8383
  • Fax:
Mailing address:
  • Phone: 515-708-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA164475
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License NumberA164475
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: