Individual
JACQUELYN STAJCAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19942 SAINT JOSEPH DR, CENTERVILLE, IA 52544-8849
(641) 856-8684
Mailing address
313 N 13TH ST, CENTERVILLE, IA 52544-1737
(641) 895-7620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A125696
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A125696
LICENSE
IA
Enumeration date
02/17/2017
Last updated
02/14/2019
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