Provider Demographics
NPI:1790589422
Name:TUBBS, GRACE FORSYTH (PA-C)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:FORSYTH
Last Name:TUBBS
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 1:6000 UNIVERSITY AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8229
Mailing Address - Country:US
Mailing Address - Phone:515-241-2000
Mailing Address - Fax:515-241-2009
Practice Address - Street 1:6000 UNIVERSITY AVE STE 450
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8229
Practice Address - Country:US
Practice Address - Phone:515-241-2000
Practice Address - Fax:515-241-2005
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA134534363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical