Provider Demographics
NPI:1417201260
Name:GIERSZ, THERESA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:GIERSZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5091 ANDRUS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4302
Mailing Address - Country:US
Mailing Address - Phone:330-888-5436
Mailing Address - Fax:330-670-8569
Practice Address - Street 1:4807 ROCKSIDE ROAD
Practice Address - Street 2:STE 110
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131
Practice Address - Country:US
Practice Address - Phone:216-520-0765
Practice Address - Fax:216-520-1427
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13646-NP363LA2200X
OHCOA13646NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health