MEDICARE: MS. JENNIFER LOCK OMAN LISW

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	1041C0700X	Clinical Social Worker	00632	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	48288	OTHER		WELLMARK BCBS OF IOWA

General Provider Information

NPI Number	:	1689751042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LOCK OMAN LISW

Provider Business Mailing Address
First Line	:	3010 FOX HOLLOW CIR
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50321-1457
Country	:	US
Telephone Number	:	515-259-9808
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 FOX HOLLOW CIR
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50321-1457
Country	:	US
Telephone Number	:	515-259-9808
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	05/12/2025

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