Healthcare Provider Details
I. General information
NPI: 1720084387
Provider Name (Legal Business Name): LINDA KAY GEHRKE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/28/2005
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date: 07/17/2007
Reactivation Date: 12/04/2007
III. Provider practice location address
405 S STATE STREET HUBBARD MEDICAL CLINIC
HUBBARD IA
50122-0487
US
IV. Provider business mailing address
PO BOX 487
HUBBARD IA
50122-0487
US
V. Phone/Fax
- Phone: 641-864-3301
- Fax: 641-864-3304
- Phone: 641-864-3301
- Fax: 641-864-3304
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 036438 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: