Provider Demographics
NPI:1114916285
Name:SILLS, JENNIFER L (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:SILLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:HUSEBOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 3014
Mailing Address - Street 2:1215 DUFF AVE MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4400
Mailing Address - Fax:515-239-4446
Practice Address - Street 1:ISU THIELEN STUDENT HEALTH CENTER
Practice Address - Street 2:2647 UNION DRIVE
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-2029
Practice Address - Country:US
Practice Address - Phone:515-294-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH-094265363L00000X
IAJ094265363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0419663Medicaid
IAP01708Medicare UPIN
IA0419663Medicaid