Provider Demographics
NPI:1386191211
Name:GERKEN, MEGHAN (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:GERKEN
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 ROAD I
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-8014
Mailing Address - Country:US
Mailing Address - Phone:402-363-1331
Mailing Address - Fax:
Practice Address - Street 1:5930 S 58TH ST
Practice Address - Street 2:SUITE W
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6402
Practice Address - Country:US
Practice Address - Phone:402-423-6402
Practice Address - Fax:402-423-6422
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72693163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant