Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | G161858 | IA |
NPI | 1013525054 |
---|---|
Provider Name | Jennifer Stromgren |
First Address | Ottumwa, IA 52501-4246 |
Second Address | Ottumwa, IA 52501-3907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2020 |
Last Update Date | 20/05/2021 |