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General NPI Number Information
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NPI Number | 1386338085
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Entity Type | Individual
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Provider Name | JACLYN MARIE HOUSEAL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 4025 WESTMARK DR
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City | DUBUQUE
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State | IA
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Zip | 52002-2626
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Country | US
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Telephone | 563-583-9300
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Fax | 563-557-5574
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Provider Business Mailing Address
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Address Line | 26938 CENTERVILLE RD
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City | LA MOTTE
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State | IA
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Zip | 52054-9563
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Country | US
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Telephone | 563-513-1915
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 150024
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A174674
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License Number State | IA
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