Provider Demographics
NPI:1073223996
Name:GERBER, BRISTIAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRISTIAN
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DULUTH ST
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8557
Mailing Address - Country:US
Mailing Address - Phone:319-538-3336
Mailing Address - Fax:
Practice Address - Street 1:715 SW ANKENY RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5999
Practice Address - Country:US
Practice Address - Phone:515-289-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
568946544OtherBCBS
DC236Medicaid
5874OtherHEALTH PARTNERS