DR. JACQUELINE ANN ELLISON (NPI# 1437766201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437766201 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE ANN ELLISON |
| Other Name | JACQUELINE ANN BRUNGARDT |
| Credential | DNP, ARNP, FNP-C |
| Practice Address |
101 E 2nd St Ida Grove IA 51445 |
| Mailing Address |
906 Lakeshore Dr Lakeside IA 50588-7672 |
| Practice Telephone | 7123642300 |
| Mailing Telephone | 7122993359 |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A160841 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2540 N Ave, Denison, IA 514427584 | 7122633033 |
| Street Address |
101 E 2ND ST |
| City | IDA GROVE |
| State | IA |
| Zip Code | 51445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518320241 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 202 Susan Lawrence Drive, Ida Grove, IA 51445 | 2016-03-31 |
| 1508162264 | Midwest Properties of Ida Grove L.L.C. | Assisted Living Facility | 800 Byron Godbersen Dr, Ida Grove, IA 51445 | 2011-01-28 |
| 1497767099 | Laura M Parks | Dentist | 700 East 2nd St, Ida Grove, IA 51445 | 2006-08-12 |
| 1437216801 | Jay Jerald Bleil | Chiropractor | 616 2nd St, Ida Grove, IA 51445-1012 | 2007-01-03 |
| 1851714638 | Ida Family Chiropractic Incorporated | Chiropractor | 616 2nd St, Ida Grove, IA 51445-1012 | 2014-01-29 |
| 1831539162 | Debra Ann Ulrich | Chiropractor | 616 2nd St, Ida Grove, IA 51445-1012 | 2013-07-01 |
| 1740650613 | Heather Marie Conover | Counselor | 106 Green St, Ida Grove, IA 51445-1028 | 2015-10-04 |
| 1043292949 | Family Eye Care of Ida Grove PC | Optometrist | 415 2nd St, Ida Grove, IA 51445-1302 | 2005-11-16 |
| 1548756760 | Malinda Lynne Alm | Pharmacist | 401 2nd St, Ida Grove, IA 51445-1302 | 2018-07-11 |
| 1730675414 | Courtney Donnelli | Pharmacist | 401 2nd St, Ida Grove, IA 51445-1302 | 2018-07-06 |
| Find all providers in zip 51445 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427604305 | Amanda K Lefebvre | Nurse Practitioner | 101 2nd St, Ida Grove, IA 51445-1401 | 2019-08-15 |
| 1811493679 | June Marie Myler | Nurse Practitioner | 101 2nd St, Ida Grove, IA 51445-1401 | 2018-04-02 |
| 1699122085 | Michelle R Doty | Nurse Practitioner | 700 E 2nd St, Ida Grove, IA 51445-1601 | 2016-05-16 |
| 1790156669 | Sarah Kent | Nurse Practitioner | 101 2nd St, Ida Grove, IA 51445-1401 | 2015-10-16 |
| 1396186136 | Joey J Hoefling | Nurse Practitioner | 101 2nd St, Ida Grove, IA 51445-1401 | 2013-07-09 |
| 1710175112 | Sara Nicole Luft | Nurse Practitioner | 101 2nd St, Ida Grove, IA 51445-1401 | 2007-10-10 |
| 1366498529 | Wanda D Freese | Nurse Practitioner | 700 E 2nd St, Ida Grove, IA 51445-1601 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950032 | Mary Christine Pope | Nurse Practitioner | 1023 E Avenue, Scranton, IA 51462-7520 | 2020-10-23 |
| 1922607936 | Alisse Anna Diers | Nurse Practitioner | 346 2nd Ave Sw # 303, Cedar Rapids, IA 52404-2045 | 2020-10-21 |
| 1043818941 | Leslie Brooke Charleville | Nurse Practitioner | 10001 95th Ave, Indianola, IA 50125-7181 | 2020-10-13 |
| 1467050674 | Sarah Schoner | Nurse Practitioner | 801 East Grand Avenue, Mount Pleasant, IA 52641 | 2020-10-12 |
| 1669088654 | Jinxia Peng | Nurse Practitioner | 9823 Biscayne Dr, Johnston, IA 50131-3002 | 2020-09-16 |
| 1093320392 | Ryan Michael Winder | Nurse Practitioner | 615 A Ave Se, Mount Vernon, IA 52314-1532 | 2020-09-14 |
| 1659986594 | Matthew John Garred | Nurse Practitioner | 420 Driftwood Ct, Sioux City, IA 51104-2200 | 2020-09-08 |
| 1699389882 | Mary Ann Shaw | Nurse Practitioner | 207 W Main Ave, Rockford, IA 50468-1213 | 2020-09-04 |
| 1588277404 | Alyson Seamer | Nurse Practitioner | 8455 Ridgeview Dr, Des Moines, IA 50320-6954 | 2020-08-29 |
| 1114530045 | Brittany Ann Enlow | Nurse Practitioner | 620 E Washington St, Washington, IA 52353-2031 | 2020-08-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.