Healthcare Provider Details

I. General information

NPI: 1205716131
Provider Name (Legal Business Name): JENNA WESTENDORF DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 S MUCKEY ST STE 120
MAPLETON IA
51034-1055
US

IV. Provider business mailing address

513 S MUCKEY ST STE 120
MAPLETON IA
51034-1055
US

V. Phone/Fax

Practice location:
  • Phone: 712-882-2234
  • Fax:
Mailing address:
  • Phone: 712-882-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number162638
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number162638
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: