Provider Demographics
NPI:1326024688
Name:GERKAN, BETH A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:GERKAN
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:PO BOX 45680
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0680
Mailing Address - Country:US
Mailing Address - Phone:530-333-2555
Mailing Address - Fax:503-333-8232
Practice Address - Street 1:6065 STATE HIGHWAY 193
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:CA
Practice Address - Zip Code:95634-9623
Practice Address - Country:US
Practice Address - Phone:530-333-2555
Practice Address - Fax:503-333-8232
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA417801163W00000X
CANP11335363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant