Provider Demographics
NPI:1407862543
Name:GERSTEIN, JOANN (ARNP)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:GERSTEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:GERSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 1011
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-1011
Mailing Address - Country:US
Mailing Address - Phone:561-840-7578
Mailing Address - Fax:561-863-0590
Practice Address - Street 1:2151 45TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2026
Practice Address - Country:US
Practice Address - Phone:561-840-7578
Practice Address - Fax:561-863-0590
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1092782363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000Y3436AMedicare ID - Type Unspecified