Provider Demographics
NPI:1851407555
Name:GERDES, MELISSA ANNE CATES (MPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE CATES
Last Name:GERDES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 W WASHINGTON ST STE B
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3837
Mailing Address - Country:US
Mailing Address - Phone:775-364-0700
Mailing Address - Fax:775-461-0215
Practice Address - Street 1:623 W WASHINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3837
Practice Address - Country:US
Practice Address - Phone:775-364-0700
Practice Address - Fax:775-461-0215
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2945225100000X
NY62 021296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist