Individual
DR. JACQUELINE ANN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, FNP-C
Contact information
Practice address
2015 W 5TH ST, STORM LAKE, IA 50588-3000
(712) 732-6650
(712) 732-6632
Mailing address
2015 W 5TH ST, STORM LAKE, IA 50588-3000
(712) 732-6650
(712) 732-6632
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A160841
IA
Other
Enumeration date
09/25/2020
Last updated
07/05/2023
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