MEDICARE: JACKLYN SUE HOSKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	002263	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	002263	OTHER	IA	IOWA LICENSE

General Provider Information

NPI Number	:	1275991804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKLYN SUE HOSKINS

Provider Business Mailing Address
First Line	:	1208 N LINCOLN ST
Second Line	:
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-3421
Country	:	US
Telephone Number	:	641-628-6623
Fax Number	:	641-621-2223

Provider Business Practice Location Address
First Line	:	1208 N LINCOLN ST
Second Line	:
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-3421
Country	:	US
Telephone Number	:	641-628-6623
Fax Number	:	641-621-2223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2016
Last Update Date	:	11/24/2020

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Directions to “ JACKLYN SUE HOSKINS ” Practice Location

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