Individual
JILLIAN APRIL REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6001 WESTOWN PKWY, WEST DES MOINES, IA 50266-7719
(515) 224-1414
(515) 224-5140
Mailing address
6001 WESTOWN PKWY, WEST DES MOINES, IA 50266-7719
(515) 224-1414
(515) 224-5140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002415
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002415
IOWA PHYSICIAN ASSISTANT LICENSE
IA
Enumeration date
07/18/2013
Last updated
12/30/2022
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