Provider Demographics
NPI:1023909447
Name:GEBAUER, MAGGIE (PA-C)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:GEBAUER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 674721
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4721
Mailing Address - Country:US
Mailing Address - Phone:515-643-2519
Mailing Address - Fax:515-222-7601
Practice Address - Street 1:1601 NW 114TH ST STE 342
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7036
Practice Address - Country:US
Practice Address - Phone:515-222-7600
Practice Address - Fax:515-222-7601
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA133508363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant