Kristine M Staheli Jackson

LBN: Kristine M Staheli Jackson
Kristine M Staheli Jackson is an health care organization with primary practice located at Hillcrest Family Services Clinic 220 W 7Th St, Dubuque IA 52001. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Kristine M Staheli Jackson can be contacted via phone (563) 583-6431, or through Gansemer, Gary via phone (563) 583-7357.

Contact Information

Primary practice address
Hillcrest Family Services Clinic 220 W 7Th St Dubuque IA 52001
Phone: (563) 583-6431
Fax: (563) 557-4447
Website:
Map and Directions
Authorized official contact:
Name: Gansemer, Gary
Phone: (563) 583-7357

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X F066142 Iowa

Profile Details

NPI number 1205847845
LBN Legal business name Kristine M Staheli Jackson
DBA Doing business as
Authorized official Gansemer, Gary
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205847845 NPPES
Iowa MEDICAID 0140087
Iowa Other 1621653

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