Provider Demographics
NPI:1598284796
Name:VOUGHT, JENNIFER DAWN (ARNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAWN
Last Name:VOUGHT
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 1:1524 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-1070
Mailing Address - Country:US
Mailing Address - Phone:515-332-8808
Mailing Address - Fax:515-332-8811
Practice Address - Street 1:1524 10TH AVE N
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1070
Practice Address - Country:US
Practice Address - Phone:515-890-0156
Practice Address - Fax:515-332-8811
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG171626363LP0808X
IAA095351363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health