| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JENNIFER DIANE PAVLISIN | 1760996987 | 2022-10-01 |
Jennifer Diane Pavlisin [F] graduated in 2017 and primarily specializes in Nurse Practitioner.
Jennifer Diane Pavlisin is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1760996987. Registration indicates Jennifer Diane Pavlisin is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 3274894258 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Jennifer Diane Pavlisin ANP |
| Practice Office Address | 1221 PLEASANT ST STE 100 DES MOINES, IA US |
| Practice Office Telephone | 5152822921 |
| Practice Office Fax | 5152821035 |
| Mailing Address | 1221 PLEASANT ST STE 100 DES MOINES, IA 503091424 US |
| Business Telephone | 5152822921 |
| Business Fax | 5152821035 |
| FHIR URL [] | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
| Code | Practice | License No State |
|---|---|---|
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 2018001756
MO |