Healthcare Provider Details

I. General information

NPI: 1538701016
Provider Name (Legal Business Name): KARLIE M MAXWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SW STATE ST STE A
ANKENY IA
50023-2555
US

IV. Provider business mailing address

2806 NW 25TH STREET ANKENY, IA 50023
ANKENY IA
50023
US

V. Phone/Fax

Practice location:
  • Phone: 515-620-2558
  • Fax:
Mailing address:
  • Phone: 712-309-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-60706
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: