1578216263 NPI number — MRS. JESSICA RAE UHLMANN ARNP

Table of content: MRS. JESSICA RAE UHLMANN ARNP (NPI 1578216263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578216263 NPI number — MRS. JESSICA RAE UHLMANN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UHLMANN
Provider First Name:
JESSICA
Provider Middle Name:
RAE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HRUBY
Provider Other First Name:
JESSICA
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578216263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2431 WILEY BLVD SW # 1013
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52404-6003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-666-4224
Provider Business Mailing Address Fax Number:
877-384-3106

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 1ST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORALVILLE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52241-1192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-666-4224
Provider Business Practice Location Address Fax Number:
877-384-3106
Provider Enumeration Date:
02/02/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  A165857 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)