Provider Demographics
NPI:1063567931
Name:SCHAACK, JESSICA J (ARNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:J
Last Name:SCHAACK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1215 PLEASENT STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1409
Mailing Address - Country:US
Mailing Address - Phone:515-241-5710
Mailing Address - Fax:515-241-8004
Practice Address - Street 1:1215 PLEASENT STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1409
Practice Address - Country:US
Practice Address - Phone:515-241-5710
Practice Address - Fax:515-241-8004
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH-109116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAH-109116OtherADULT NURSE PRACTITIONER