Provider Demographics
NPI:1407136062
Name:GERHARDSTEIN, BRANDI JO
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:JO
Last Name:GERHARDSTEIN
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 1:5507 COUNTY ROAD 177
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-9475
Mailing Address - Country:US
Mailing Address - Phone:419-650-8720
Mailing Address - Fax:
Practice Address - Street 1:5507 COUNTY ROAD 177
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9475
Practice Address - Country:US
Practice Address - Phone:419-650-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 316837163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine