Individual
MAUREEN TACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5900 E UNIVERSITY AVE STE 100, PLEASANT HILL, IA 50327-8467
(515) 643-2400
(515) 643-4766
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-2400
(515) 643-4766
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO-04052
IA
390200000X
Student in an Organized Health Care Education/Training Program
R8456
IA
Other
Enumeration date
07/11/2008
Last updated
01/23/2025
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