Basic Information
Provider Information
NPI: 1285956920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILLASPIE
FirstName: SARAH
MiddleName: MARGUERITE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1475
Address2:  
City: DES MOINES
State: IA
PostalCode: 503051475
CountryCode: US
TelephoneNumber: 5152474240
FaxNumber: 5152474239
Practice Location
Address1: 1111 6TH AVE
Address2:  
City: DES MOINES
State: IA
PostalCode: 503142610
CountryCode: US
TelephoneNumber: 5152474240
FaxNumber: 5152474239
Other Information
ProviderEnumerationDate: 02/23/2010
LastUpdateDate: 06/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X103333IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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