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General NPI Number Information
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NPI Number | 1437815040
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Entity Type | Organization
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Legal Business Name | DR JENNI L MCCANN CORPORATION
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 2600 DODGE ST STE D5
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City | DUBUQUE
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State | IA
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Zip | 52003-7161
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Country | US
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Telephone | 563-590-1399
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 DODGE ST STE D5
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City | DUBUQUE
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State | IA
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Zip | 52003-7161
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Country | US
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Telephone | 563-590-1399
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Fax |
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Authorized Official
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Title or Position | ARNP/OWNER
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Name | JENNI LOU MCCANN
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Credential | RN, ARNP, PMHNP-BC
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Telephone | 563-590-1399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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