Provider Demographics
NPI:1275229346
Name:GERLACH, ALISON (AGNP-C)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GERLACH
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 PITMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4312
Mailing Address - Country:US
Mailing Address - Phone:513-766-6125
Mailing Address - Fax:
Practice Address - Street 1:203 PLYMOUTH AVE STE 701
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-4300
Practice Address - Country:US
Practice Address - Phone:508-235-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2298067363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner