Individual
MRS. JACLYN MAE FREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 OAK ST, SHELDON, IA 51201-1242
(712) 324-5356
(712) 324-6515
Mailing address
800 OAK ST, P.O. BOX 10, SHELDON, IA 51201-1242
(712) 324-5356
(712) 324-6515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001484
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0254656
—
IA
05
—
0638593
—
IA
Enumeration date
04/11/2006
Last updated
04/18/2022
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