Provider Demographics
NPI:1558004093
Name:VANDER PLOEG, JORDAN ALANA (PA-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ALANA
Last Name:VANDER PLOEG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 677080
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-7080
Mailing Address - Country:US
Mailing Address - Phone:515-633-3600
Mailing Address - Fax:515-633-3838
Practice Address - Street 1:411 LAUREL ST STE A250
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3029
Practice Address - Country:US
Practice Address - Phone:515-235-5000
Practice Address - Fax:515-288-6713
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2025-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA121640363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program