Healthcare Provider Details

I. General information

NPI: 1679977482
Provider Name (Legal Business Name): JENNIFER JOY BECKER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 10/08/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-9979
  • Fax: 319-353-8073
Mailing address:
  • Phone: 319-384-9979
  • Fax: 319-353-8073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberH113225
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: