Individual
JENNIFER L WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-6360
(319) 384-9184
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-6360
(319) 384-9184
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001786
IA
363AM0700X
Medical Physician Assistant
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05600
WELLMARK BCBS
IA
01
—
P00300828
RAILROAD MEDICARE
IL
Enumeration date
03/09/2007
Last updated
11/26/2007
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