Healthcare Provider Details

I. General information

NPI: 1124988076
Provider Name (Legal Business Name): JAMIE JEAN RUMMEL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE JEAN DONIVAN

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 UNIVERSITY AVE STE 100
WATERLOO IA
50701-5656
US

IV. Provider business mailing address

4000 UNIVERSITY AVE STE 100
WATERLOO IA
50701-5656
US

V. Phone/Fax

Practice location:
  • Phone: 319-235-1230
  • Fax: 319-235-1229
Mailing address:
  • Phone: 319-235-1230
  • Fax: 319-235-1229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberP52026
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: