Provider Demographics
NPI:1477902377
Name:GIERKE, KRISTY JOANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:JOANNE
Last Name:GIERKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-7521
Mailing Address - Country:US
Mailing Address - Phone:912-712-2550
Mailing Address - Fax:912-480-0518
Practice Address - Street 1:1601 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-7521
Practice Address - Country:US
Practice Address - Phone:912-712-2550
Practice Address - Fax:912-480-0518
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7973363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20297I8518Medicare PIN