Provider Demographics
NPI:1609656412
Name:NATURAL HEALTH FAMILY MEDICINE CLINIC
Entity Type:Organization
Organization Name:NATURAL HEALTH FAMILY MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TIERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:515-229-7527
Mailing Address - Street 1:904 NW BOULDER POINT PL
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8798
Mailing Address - Country:US
Mailing Address - Phone:515-229-7527
Mailing Address - Fax:
Practice Address - Street 1:2301 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2470
Practice Address - Country:US
Practice Address - Phone:515-229-7527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty