| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JODI LYNNE WILSON | 1861901555 | 2022-06-19 |
Jodi L Wilson [F] graduated in 2017 and primarily specializes in Nurse Practitioner.
Jodi Lynne Wilson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1861901555. Registration indicates Jodi Lynne Wilson 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: Acute Care, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Acute Care, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 3971860180 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Jodi Lynne Wilson ARNP |
| Other Provider Name | Jodi Lynne Shaffer |
| Practice Office Address | 411 LAUREL ST STE 2100 DES MOINES, IA US |
| Practice Office Telephone | 5152473266 |
| Practice Office Fax | 5156438688 |
| Mailing Address | PO BOX 1475 DES MOINES, IA 503051475 US |
| Business Telephone | 5152473266 |
| Business Fax | 5156438688 |
| Code | Practice | License No State |
|---|---|---|
| 363LA2100X 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: Acute Care All Other Specialties & Provider Types Nurse Practitioner Acute Care Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | H131394
IA |