Organization
CORRIDOR KETAMINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CECIL SASSMAN (ARNP/CREDENTIALING)
(319) 337-8329
Entity
Organization
Contact information
Practice address
1900 JAMES ST STE 1, CORALVILLE, IA 52241-1895
(319) 337-8329
Mailing address
1900 JAMES ST STE 1, CORALVILLE, IA 52241-1895
(319) 337-8329
(319) 337-8692
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
06/19/2025
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