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General NPI Number Information
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NPI Number | 1710256631
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Entity Type | Individual
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Provider Name | JESSICA R MISKELL INDEPENDENT APN
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Gender | Female
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 218 W MADISON ST
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City | OTTAWA
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State | IL
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Zip | 61350-2819
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Country | US
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Telephone | 815-431-1122
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Fax | 877-503-2851
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Provider Business Mailing Address
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Address Line | 218 W MADISON ST
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City | OTTAWA
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State | IL
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Zip | 61350-2819
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Country | US
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Telephone | 815-431-1122
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Fax | 877-503-2851
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 209009286
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 209009286
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 277000895
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209009286
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 277000895
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209009286
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 277000895
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277000895
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License Number State | IL
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