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General NPI Number Information
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NPI Number | 1164725339
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Entity Type | Individual
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Provider Name | JUDITH ANN GONZALES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 8460 BIRCHWOOD COURT SUITE 700
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City | JOHNSTON
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State | IA
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Zip | 50131
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Country | US
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Telephone | 515-229-2318
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Fax | 515-214-1946
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Provider Business Mailing Address
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Address Line | 2213 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5305
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Country | US
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Telephone | 515-237-3974
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Fax | 515-883-2692
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G079336
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | G-079336
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License Number State | IA
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