Provider Demographics
NPI:1609285279
Name:VANTIGER, DEAN JEFFREY (CFNP)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:JEFFREY
Last Name:VANTIGER
Suffix:
Gender:M
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21308 245TH ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:IA
Mailing Address - Zip Code:52660-9715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1307 S GEAR AVE
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1604
Practice Address - Country:US
Practice Address - Phone:319-768-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA117271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily