Provider Demographics
NPI:1831685023
Name:MEIS, JACLYN LEIGH
Entity type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:LEIGH
Last Name:MEIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:LEIGH
Other - Last Name:HULETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3453 STONE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-2336
Mailing Address - Country:US
Mailing Address - Phone:712-266-6066
Mailing Address - Fax:
Practice Address - Street 1:230 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1733
Practice Address - Country:US
Practice Address - Phone:712-252-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA127394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily