Individual
SAMANTHA J JIRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
504 N 9TH AVE, VINTON, IA 52349-2254
(319) 472-6300
Mailing address
504 N 9TH AVE, VINTON, IA 52349-2254
(319) 472-6300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A136122
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
G136122
IA
Other
Enumeration date
10/04/2018
Last updated
12/01/2020
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