Provider Demographics
NPI:1962474825
Name:GERTZ, JANE E (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:E
Last Name:GERTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 CROSS PARK DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4602
Mailing Address - Country:US
Mailing Address - Phone:865-777-6880
Mailing Address - Fax:865-777-6881
Practice Address - Street 1:9031 CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4602
Practice Address - Country:US
Practice Address - Phone:865-777-6880
Practice Address - Fax:865-777-6881
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2028812363LF0000X
AL1-118334363LF0000X
TNAPN0000020321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ023878Medicaid
TNQ023878Medicaid
TN10350I2771Medicare PIN
TNP01647734Medicare PIN
TN10350I2310Medicare PIN
TN10350I2269Medicare PIN