Provider Demographics
NPI:1790061851
Name:GERST, PAMELA L (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:GERST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WITTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WHITNEY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:13862-1420
Mailing Address - Country:US
Mailing Address - Phone:607-692-2493
Mailing Address - Fax:
Practice Address - Street 1:40 S CANAL ST
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:NY
Practice Address - Zip Code:13778-1236
Practice Address - Country:US
Practice Address - Phone:607-656-4161
Practice Address - Fax:607-656-4044
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY599842163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool