Provider Demographics
NPI:1366315129
Name:IHDE, RACHEL B
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:B
Last Name:IHDE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 NORTHWESTERN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-2935
Mailing Address - Country:US
Mailing Address - Phone:712-732-5030
Mailing Address - Fax:
Practice Address - Street 1:620 NORTHWESTERN DR STE 1
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-2935
Practice Address - Country:US
Practice Address - Phone:712-358-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-27
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA109489363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty