Provider Demographics
NPI:1790329480
Name:SANDBECK, ALLISON GRACE
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:GRACE
Last Name:SANDBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E MICHIGAN AVE # 755
Mailing Address - Street 2:
Mailing Address - City:GEORGE
Mailing Address - State:IA
Mailing Address - Zip Code:51237-7719
Mailing Address - Country:US
Mailing Address - Phone:712-475-3887
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLN CIR SE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1836
Practice Address - Country:US
Practice Address - Phone:712-737-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF09190381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily