IndividualActive
Alec Antanaitis
NPI 1104715770 · Gerontology Nurse Practitioner · Jefferson, IA
Provider details
- NPI number
- 1104715770
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- H184694 (IA)
Practice location
1000 W Lincoln Way
Jefferson, IA 50129-1685
Phone: (515) 386-2114
Fax: (515) 386-8899
Mailing address
1002 W Lincoln Way
Jefferson, IA 50129-1645
Registry dates
- Enumerated
- 2025-06-30
- Last updated
- 2026-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.