Individual
JANE DONNETTE SIELEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
905 FRANKLIN ST, WATERLOO, IA 50703-4407
(319) 272-4300
Mailing address
905 FRANKLIN ST, WATERLOO, IA 50703-4407
(319) 272-4300
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
C-050348
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076372
—
IA
01
—
15689
WELLMARK BCBS
IA
01
—
5200529
IOWA CONTROLLED SUBSTANCE
IA
01
—
C050348
IOWA STATE LICENSE #
IA
Enumeration date
01/12/2006
Last updated
03/07/2023
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