Provider Demographics
NPI:1982913141
Name:WHITMAN, JESSICA RAE (ARNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1068
Mailing Address - Country:US
Mailing Address - Phone:319-560-2016
Mailing Address - Fax:
Practice Address - Street 1:301 W 2ND ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2506
Practice Address - Country:US
Practice Address - Phone:641-435-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC-121201163WP0200X
IAC121201363LP0200X
MO2011026731363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics