Healthcare Provider Details

I. General information

NPI: 1801728746
Provider Name (Legal Business Name): AMY JIPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 PLAZA CIR STE A
WATERLOO IA
50701-5139
US

IV. Provider business mailing address

3726 BROOMFIELD DR
CEDAR FALLS IA
50613-9248
US

V. Phone/Fax

Practice location:
  • Phone: 319-236-7720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA194005
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: