| NPI | 1710622758 |
|---|---|
| Former Name | NICOLE RAE GERTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012630A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28240035C) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-07-21 |