Provider Demographics
NPI:1467402081
Name:DANKENBRING, GERALD N (ARNP)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:N
Last Name:DANKENBRING
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34958-0021
Mailing Address - Country:US
Mailing Address - Phone:772-334-1969
Mailing Address - Fax:
Practice Address - Street 1:2496 NE ELAINE ST
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-5802
Practice Address - Country:US
Practice Address - Phone:772-334-1969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9176439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ67816Medicare UPIN
FLY3823BMedicare PIN