Provider Demographics
NPI:1740272855
Name:SLEITER, JENNIFER R (ARNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:SLEITER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:EDGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 PLEASANT ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1416
Mailing Address - Country:US
Mailing Address - Phone:515-241-4311
Mailing Address - Fax:515-241-4320
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:SUITE 303
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1416
Practice Address - Country:US
Practice Address - Phone:515-241-4311
Practice Address - Fax:515-241-4320
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC096977363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0433342Medicaid
IA0433342Medicaid
I12989Medicare ID - Type Unspecified