Provider Demographics
NPI:1437526258
Name:CHRISTEN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CHRISTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52537-1271
Mailing Address - Country:US
Mailing Address - Phone:641-664-3832
Mailing Address - Fax:641-664-1857
Practice Address - Street 1:509 N MADISON ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IA
Practice Address - Zip Code:52537-1271
Practice Address - Country:US
Practice Address - Phone:641-664-3832
Practice Address - Fax:641-664-1857
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027434363LF0000X
IAA170893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily