Provider Demographics
NPI:1336617117
Name:GERK, HANNAH LAURA (RDH)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LAURA
Last Name:GERK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ANSGAR
Mailing Address - State:IA
Mailing Address - Zip Code:50472-9505
Mailing Address - Country:US
Mailing Address - Phone:641-590-5054
Mailing Address - Fax:
Practice Address - Street 1:311 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SAINT ANSGAR
Practice Address - State:IA
Practice Address - Zip Code:50472-9505
Practice Address - Country:US
Practice Address - Phone:641-590-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IARDH-03979124Q00000X
MNH9766124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist