Provider Demographics
NPI:1619202868
Name:HACKER, JANA MARIA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:MARIA
Last Name:HACKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MANSON
Mailing Address - State:IA
Mailing Address - Zip Code:50563-5088
Mailing Address - Country:US
Mailing Address - Phone:515-408-0092
Mailing Address - Fax:
Practice Address - Street 1:20 N 29TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-2990
Practice Address - Country:US
Practice Address - Phone:515-227-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-083903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily