Individual
DR. JODI L. VANSICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
236 NATIONAL DR, WATERLOO, IA 50701-4263
(319) 272-0000
(319) 272-0016
Mailing address
2101 KIMBALL AVE, LL14, WATERLOO, IA 50702-5063
(319) 272-1590
(319) 272-1535
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31864
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1159111
—
IA
Enumeration date
06/23/2006
Last updated
07/17/2007
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