Provider Demographics
NPI:1447799234
Name:GERHARDT, WENDY DIANE (APRN-CNM)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:DIANE
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3536
Mailing Address - Country:US
Mailing Address - Phone:225-761-1200
Mailing Address - Fax:225-761-1215
Practice Address - Street 1:7941 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3536
Practice Address - Country:US
Practice Address - Phone:225-761-1200
Practice Address - Fax:225-761-1215
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA367A00000X367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife