Provider Demographics
NPI:1588800635
Name:GERYK, NANCY E (MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:GERYK
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1651
Mailing Address - Country:US
Mailing Address - Phone:215-487-1450
Mailing Address - Fax:215-487-7658
Practice Address - Street 1:6001 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1651
Practice Address - Country:US
Practice Address - Phone:215-487-1450
Practice Address - Fax:215-487-7658
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP002231D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics