Provider Demographics
NPI:1417704800
Name:MCNEILL, JASMINE MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 U AVE
Mailing Address - Street 2:
Mailing Address - City:RIPPEY
Mailing Address - State:IA
Mailing Address - Zip Code:50235-7023
Mailing Address - Country:US
Mailing Address - Phone:515-210-4750
Mailing Address - Fax:
Practice Address - Street 1:203 E PERCIVAL ST
Practice Address - Street 2:
Practice Address - City:RIPPEY
Practice Address - State:IA
Practice Address - Zip Code:50235-1001
Practice Address - Country:US
Practice Address - Phone:515-210-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA179261363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily