Healthcare Provider Details

I. General information

NPI: 1750145777
Provider Name (Legal Business Name): JACQUELINE HOJATI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 86TH ST
URBANDALE IA
50322-4309
US

IV. Provider business mailing address

2633 86TH ST
URBANDALE IA
50322-4309
US

V. Phone/Fax

Practice location:
  • Phone: 515-250-0913
  • Fax: 515-598-7697
Mailing address:
  • Phone: 515-252-2552
  • Fax: 515-598-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JACQUELINE S HOJATI
Title or Position: OWNER
Credential:
Phone: 515-252-2552