Provider Demographics
NPI:1346724713
Name:VAN VEEN, JODY L (ARNP)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:L
Last Name:VAN VEEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:L
Other - Last Name:TIMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:746 RODEO AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:IA
Mailing Address - Zip Code:50170-8787
Mailing Address - Country:US
Mailing Address - Phone:641-521-1351
Mailing Address - Fax:
Practice Address - Street 1:405 MONROE ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1290
Practice Address - Country:US
Practice Address - Phone:641-628-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA093648363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care