Provider Demographics
NPI:1609831320
Name:GERDES, PEGGY J (RN, APN)
Entity Type:Individual
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First Name:PEGGY
Middle Name:J
Last Name:GERDES
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Gender:F
Credentials:RN, APN
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Mailing Address - Street 1:68 HARMON DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IL
Mailing Address - Zip Code:62254-1117
Mailing Address - Country:US
Mailing Address - Phone:618-537-6248
Mailing Address - Fax:618-537-6248
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-289-7029
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology