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General NPI Number Information
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NPI Number | 1013564996
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Entity Type | Individual
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Provider Name | JENNIFER LEE WITTMAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2019
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1900 JAMES ST STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-1895
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Country | US
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Telephone | 319-337-8329
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Fax | 319-379-6156
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Provider Business Mailing Address
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Address Line | 1900 JAMES ST STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-1895
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Country | US
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Telephone | 319-936-4545
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Fax | 319-379-6156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A156218
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G156884
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License Number State | IA
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