Active NPI
Nicole Marie Josselyn, CNM
- Advanced Practice Midwife
- Council Bluffs, IA
National Provider Identifier
1376738492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- B-115389
- Practice address
- 162 Glen Ave
Council Bluffs, IA 51503-6636 - Phone
- (712) 256-9989
- Fax
- (712) 256-9989
- NPI assigned
- Sep 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | B-115389 | IA | Primary |
Addresses
Primary practice location
162 Glen Ave
Council Bluffs, IA 51503-6636
Mailing address
162 Glen Ave
Council Bluffs, IA 51503-6636
Phone (712) 256-9989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B-115389 | IA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1376738492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 GLEN AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515036636",
"telephone_number": "712-256-9989",
"fax_number": "712-256-9989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 GLEN AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515036636",
"telephone_number": "712-256-9989",
"fax_number": "712-256-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSSELYN",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "IA",
"license": "B-115389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.