Provider Demographics
NPI:1295829794
Name:LAMBERT, GERTRUDE (FNP)
Entity Type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43500 MIGIZI
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:53359
Mailing Address - Country:US
Mailing Address - Phone:800-709-6445
Mailing Address - Fax:320-532-7831
Practice Address - Street 1:43500 MIGIZI
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:53359
Practice Address - Country:US
Practice Address - Phone:800-709-6445
Practice Address - Fax:320-532-7831
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0535818363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN86514100Medicaid