Provider Demographics
NPI:1811586506
Name:GERHART, LOUIEANN
Entity Type:Individual
Prefix:
First Name:LOUIEANN
Middle Name:
Last Name:GERHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49656 GOLDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-4090
Mailing Address - Country:US
Mailing Address - Phone:586-216-8907
Mailing Address - Fax:
Practice Address - Street 1:49656 GOLDEN PARK DR
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-4090
Practice Address - Country:US
Practice Address - Phone:586-216-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704324574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse