JACQUELINE WILLMS (NPI# 1417599549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417599549 |
| Entity Type | Individual |
| Full Name | JACQUELINE WILLMS |
| Credential | PHARM.D. |
| Practice Address |
2055 Kimball Ave Ste 101 Waterloo IA 50702-5047 |
| Practice Telephone | 6412290146 |
| Mailing Telephone | 6412290146 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2020-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 23617 | IA | Pharmacy Service Providers |
| Street Address |
2055 KIMBALL AVE STE 101 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154309870 | Cindy L Huwe | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2006-01-03 |
| 1225656556 | Lesley Anna Green | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2020-07-13 |
| 1790309789 | Ashley Renee Dohlman | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2020-06-04 |
| 1497240188 | Stanley Michael Nickarz | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-06-26 |
| 1518451970 | Andrew Chang | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-06-19 |
| 1073007894 | Elise A G Duwe | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-06-15 |
| 1134610579 | Ektaben Sanket Patel | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-05-22 |
| 1508356460 | Shadi Suhail Mustafa | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-05-16 |
| 1467942227 | Inger Johanne Lied | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2018-05-16 |
| 1073035549 | Shamim S Khan | Family Medicine | 2055 Kimball Ave Ste 101, Waterloo, IA 50702-5047 | 2017-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395448 | Amanda Hurtt | Pharmacist | 961 N Market St Stop 1, Waterloo, IL 62298-1061 | 2020-10-31 |
| 1710599592 | Shane Cieri | Pharmacist | 570 Waterloo Geneva Rd, Waterloo, NY 13165-1240 | 2020-08-21 |
| 1386273159 | Samantha Lynn Lenzendorf | Pharmacist | N7121 Newville Rd, Waterloo, WI 53594-9534 | 2020-04-03 |
| 1548645070 | Rosie Callaghan | Pharmacist | 1929 Us Route 20, Waterloo, NY 13165-9453 | 2015-07-27 |
| 1801286612 | Dino Pitta | Pharmacist | N7421 Mulderink Ln, Waterloo, WI 53594-9437 | 2015-02-01 |
| 1255778825 | Laura J Peloquin | Pharmacist | 1825 Logan Ave Rm 551, Allen Hospital Anticoagulation Clinic, Waterloo, IA 50703-1916 | 2013-05-23 |
| 1508136201 | Mary Catherine Meier | Pharmacist | 1714 E Ridgeway Ave, Waterloo, IA 50702-3528 | 2012-01-11 |
| 1922375773 | David Calton | Pharmacist | 2027 Huntington Rd, Box 1528, Waterloo, IA 50701-6001 | 2011-11-22 |
| 1639452899 | Jane Workman Ivey | Pharmacist | 363 Ridgewood Dr, Waterloo, SC 29384-5011 | 2011-09-23 |
| 1033436993 | Amy Joleen Bucknell | Pharmacist | 146 W Dale St Ste 103, Waterloo, IA 50703-1901 | 2010-04-30 |
| Find all providers in WATERLOO | ||||
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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.