MEDICARE: MS. DIANA M JEFFREY ARNP

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	363L00000X	Nurse Practitioner	A093550	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00466179	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	571220779	OTHER	IA	WELLMARK BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700887866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANA M JEFFREY ARNP

Provider Business Mailing Address
First Line	:	1026 A AVE NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-5036
Country	:	US
Telephone Number	:	319-368-5970
Fax Number	:	319-368-5973

Provider Business Practice Location Address
First Line	:	1026 A AVE NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402
Country	:	US
Telephone Number	:	319-368-5970
Fax Number	:	319-368-5973

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/07/2010

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