Provider Demographics
NPI:1629248083
Name:GRUBEL, ZINKA (PA-C)
Entity Type:Individual
Prefix:
First Name:ZINKA
Middle Name:
Last Name:GRUBEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ZINKA
Other - Middle Name:
Other - Last Name:SARCHET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
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:515-222-7600
Mailing Address - Fax:515-222-7601
Practice Address - Street 1:1601 NW 114TH ST STE 342
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325
Practice Address - Country:US
Practice Address - Phone:515-222-7600
Practice Address - Fax:515-222-7601
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108350363A00000X
IA001951363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016443100Medicaid
FLAQIFGOtherBCBS
FLIK906ZOtherMEDICARE
FLIK906ZMedicare PIN