Provider Demographics
NPI:1093073686
Name:GEHRIG, MARIANN
Entity Type:Individual
Prefix:
First Name:MARIANN
Middle Name:
Last Name:GEHRIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CLARINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43915
Mailing Address - Country:US
Mailing Address - Phone:740-458-1649
Mailing Address - Fax:
Practice Address - Street 1:1069 MARKET STREET
Practice Address - Street 2:
Practice Address - City:CLARINGTON
Practice Address - State:OH
Practice Address - Zip Code:43915
Practice Address - Country:US
Practice Address - Phone:740-458-1649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH286191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse