Provider Demographics
NPI:1538673926
Name:GERBER, PHYLLIS (APN)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MADISON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7331
Mailing Address - Country:US
Mailing Address - Phone:908-219-6690
Mailing Address - Fax:908-219-6692
Practice Address - Street 1:95 MADISON AVE STE 101
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7331
Practice Address - Country:US
Practice Address - Phone:908-219-6690
Practice Address - Fax:908-219-6692
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00797400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care