Provider Demographics
NPI:1386139103
Name:VANDE ZANDE, GIULIANA (DO)
Entity type:Individual
Prefix:
First Name:GIULIANA
Middle Name:
Last Name:VANDE ZANDE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:GIULIANA
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-358-7550
Mailing Address - Fax:515-358-7551
Practice Address - Street 1:120 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8411
Practice Address - Country:US
Practice Address - Phone:515-358-7550
Practice Address - Fax:515-358-7551
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11369207Q00000X
390200000X
IADO-05797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program