Healthcare Provider Details

I. General information

NPI: 1255097820
Provider Name (Legal Business Name): JESSE MORGAN BRANSCOMB ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S CLINTON ST STE 168
IOWA CITY IA
52240-4034
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-0520
  • Fax: 319-384-0603
Mailing address:
  • Phone: 319-384-0520
  • Fax: 319-384-0603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number121436
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA166402
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA166402
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: