Provider Demographics
NPI:1457031056
Name:JUNKMAN, JOI ANN
Entity Type:Individual
Prefix:
First Name:JOI
Middle Name:ANN
Last Name:JUNKMAN
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 1:1122 MAIN ST # 1
Mailing Address - Street 2:
Mailing Address - City:MANSON
Mailing Address - State:IA
Mailing Address - Zip Code:50563-5157
Mailing Address - Country:US
Mailing Address - Phone:712-830-5959
Mailing Address - Fax:
Practice Address - Street 1:530 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5566
Practice Address - Country:US
Practice Address - Phone:515-576-2235
Practice Address - Fax:515-576-6863
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP27087164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse