Doctor Name: | LAURIE SUE GIERTZ |
NPI Number: | 1538135157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 0110001767 |
Business Practice Address: | 11131 Journal Parkway King George, VA - 22485 |
Business Phone Number: | 5407758008 |
Business Fax Number: | |
Mailing Address: | 11507 River Meadows Way, FREDERICKSBURG |
State: | VA |
Postal Code: | 224088001 |
Phone Number: | 5403741349 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2006 |
NPI Last Update Date: | 04/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0110001767 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |