Provider Demographics
NPI:1285003012
Name:TIERNAN, JESSICA (ARNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TIERNAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE 14TH ST STE 36
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8903
Mailing Address - Country:US
Mailing Address - Phone:515-289-1515
Mailing Address - Fax:515-289-1511
Practice Address - Street 1:6950 NE 14TH ST STE 36
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8903
Practice Address - Country:US
Practice Address - Phone:515-289-1515
Practice Address - Fax:515-289-1511
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA122232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily