Provider Demographics
NPI:1750618401
Name:SALCINOVIC-SPAHIC, JASMINA (PA-C)
Entity type:Individual
Prefix:
First Name:JASMINA
Middle Name:
Last Name:SALCINOVIC-SPAHIC
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 1:1171 7TH ST.
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2505
Mailing Address - Country:US
Mailing Address - Phone:515-280-7004
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:200 ARMY POST RD.
Practice Address - Street 2:STE 26
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-6203
Practice Address - Country:US
Practice Address - Phone:515-953-7560
Practice Address - Fax:515-953-7549
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002003363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1750618401OtherWELLMARK
IA1750618401OtherWELLMARK
IA1750618401Medicare Oscar/Certification