Healthcare Provider Details

I. General information

NPI: 1689115263
Provider Name (Legal Business Name): KINDRA GAULKE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KINDRA ROBERTS

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 DUFF AVE
AMES IA
50010-5740
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-663-8621
  • Fax:
Mailing address:
  • Phone: 515-987-1511
  • Fax: 515-987-3218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA133625
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA133625
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: