Healthcare Provider Details

I. General information

NPI: 1295137313
Provider Name (Legal Business Name): JESSICA WINELAND DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 INDIAN HILLS DR STE 260
SIOUX CITY IA
51104-1859
US

IV. Provider business mailing address

2704 MAGNOLIA CT
SIOUX CITY IA
51106-3804
US

V. Phone/Fax

Practice location:
  • Phone: 712-258-4700
  • Fax:
Mailing address:
  • Phone: 712-389-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA120721
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA120721
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: