Provider Demographics
NPI:1053442426
Name:GEREN, JEREL ANN (BS, CTRS, ADC)
Entity Type:Individual
Prefix:MRS
First Name:JEREL
Middle Name:ANN
Last Name:GEREN
Suffix:
Gender:F
Credentials:BS, CTRS, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WEST CAPITAL AVENUE
Mailing Address - Street 2:RM 109
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803
Mailing Address - Country:US
Mailing Address - Phone:308-385-6252
Mailing Address - Fax:308-385-6257
Practice Address - Street 1:2300 W CAPITAL AVE
Practice Address - Street 2:RM 109
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2003
Practice Address - Country:US
Practice Address - Phone:308-385-6252
Practice Address - Fax:308-385-6257
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist