Healthcare Provider Details

I. General information

NPI: 1598284796
Provider Name (Legal Business Name): JENNIFER DAWN VOUGHT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 10TH AVE N
HUMBOLDT IA
50548-1070
US

IV. Provider business mailing address

1524 10TH AVE N
HUMBOLDT IA
50548-1070
US

V. Phone/Fax

Practice location:
  • Phone: 515-890-0156
  • Fax: 515-332-8811
Mailing address:
  • Phone: 515-332-8808
  • Fax: 515-332-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA095351
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG171626
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: