Healthcare Provider Details

I. General information

NPI: 1649188301
Provider Name (Legal Business Name): ADVANCED FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 SE UNIVERSITY AVE
WAUKEE IA
50263-8831
US

IV. Provider business mailing address

1218 SE UNIVERSITY AVE
WAUKEE IA
50263-8831
US

V. Phone/Fax

Practice location:
  • Phone: 515-987-1290
  • Fax: 833-710-0690
Mailing address:
  • Phone: 515-987-1290
  • Fax: 833-710-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GARETH LOURENS
Title or Position: OWNER
Credential: DC
Phone: 515-505-2989