Healthcare Provider Details

I. General information

NPI: 1851695910
Provider Name (Legal Business Name): KELLIE MARIE GEBAUER-STEINICK RN, MSN, ARNP, CNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

325 NW WATERVIEW CT
ANKENY IA
50023-6812
US

V. Phone/Fax

Practice location:
  • Phone: 515-205-6052
  • Fax:
Mailing address:
  • Phone: 515-964-5394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberK-110843
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: