Individual
GRANT JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
501 S WHITE ST STE 1, MT PLEASANT, IA 52641-2654
(319) 385-6700
Mailing address
3407 GRAND AVE APT 301, DES MOINES, IA 50312-4137
(563) 590-7337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
093375
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093375
—
IA
Enumeration date
01/02/2019
Last updated
01/02/2019
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