Provider Demographics
NPI:1164498838
Name:GEHLING, SUE ANN (ARNP)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:ANN
Last Name:GEHLING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2344
Mailing Address - Country:US
Mailing Address - Phone:712-525-0993
Mailing Address - Fax:
Practice Address - Street 1:603 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2344
Practice Address - Country:US
Practice Address - Phone:712-525-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA085156363L00000X
IAG085156363LP0808X
IAG-085156363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0479725Medicaid
IA01274OtherWELLMARK BCBS
IA0479725Medicaid
IAI16493Medicare PIN