Doctor Name: | MS. CARRIE GERDIK |
NPI Number: | 1932451853 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 604605 |
Business Practice Address: | 50100 Golsh Rd Valley Center, CA - 920825338 |
Business Phone Number: | 7607491410 |
Business Fax Number: | |
Mailing Address: | 50100 Golsh Rd, VALLEY CENTER |
State: | CA |
Postal Code: | 920825338 |
Phone Number: | 7607491410 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2012 |
NPI Last Update Date: | 10/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LC1500X |
License Number: | 604605 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |