Provider Demographics
NPI:1710240866
Name:CARDER, JACQUELINE CHRISTINE (AUD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:CHRISTINE
Last Name:CARDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JACQUELINE
Other - Middle Name:CHRISTINE
Other - Last Name:HACKBARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:4401 6TH ST SW
Mailing Address - Street 2:GRANT WOOD AREA EDUCATION AGENCY
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4432
Mailing Address - Country:US
Mailing Address - Phone:319-731-4636
Mailing Address - Fax:
Practice Address - Street 1:4401 6TH ST SW
Practice Address - Street 2:GRANT WOOD AREA EDUCATION AGENCY
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4432
Practice Address - Country:US
Practice Address - Phone:319-731-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000744231H00000X
IA001057237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI77150005Medicare UPIN