Provider Demographics
NPI:1720084387
Name:GEHRKE, LINDA KAY (ARNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:GEHRKE
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:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:IA
Mailing Address - Zip Code:50122-0487
Mailing Address - Country:US
Mailing Address - Phone:641-864-3301
Mailing Address - Fax:641-864-3304
Practice Address - Street 1:405 S STATE STREET
Practice Address - Street 2:HUBBARD MEDICAL CLINIC
Practice Address - City:HUBBARD
Practice Address - State:IA
Practice Address - Zip Code:50122-0487
Practice Address - Country:US
Practice Address - Phone:641-864-3301
Practice Address - Fax:641-864-3304
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2024-06-27
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-12-04
Provider Licenses
StateLicense IDTaxonomies
IA036438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI17688OtherPROVIDER GROUP
IAI17689OtherMEDICARE
IA4422584Medicaid
S45457Medicare UPIN