Individual
JESSICA BOEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
309 S CHERRY STREET, SHELL ROCK, IA 50670
(319) 885-4363
(319) 885-6583
Mailing address
2101 KIMBALL AVE, LL14, WATERLOO, IA 50702-5063
(319) 272-1590
(319) 272-1535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33143
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0484303
—
IA
Enumeration date
07/20/2006
Last updated
07/13/2007
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