Provider Demographics
NPI:1194958322
Name:BERNS CLINTON, JENNIFER L (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BERNS CLINTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:BERNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-2572
Mailing Address - Fax:319-356-4505
Practice Address - Street 1:920 E 2ND AVE STE 201A&B
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2219
Practice Address - Country:US
Practice Address - Phone:319-356-2572
Practice Address - Fax:319-356-4505
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002015363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant