Provider Demographics
NPI:1740627819
Name:GERHARDT, BARBARA (RND)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:RND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54028-7017
Mailing Address - Country:US
Mailing Address - Phone:715-684-5975
Mailing Address - Fax:
Practice Address - Street 1:2417 110TH AVE
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:WI
Practice Address - Zip Code:54028-7017
Practice Address - Country:US
Practice Address - Phone:715-684-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WINONE REQUIRED175F00000X
175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath