Provider Demographics
NPI:1740720358
Name:GERLOFF, ERIN BRIANA
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:BRIANA
Last Name:GERLOFF
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 1:2511 W EDGEWOOD DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5869
Mailing Address - Country:US
Mailing Address - Phone:573-761-0304
Mailing Address - Fax:573-635-0726
Practice Address - Street 1:2511 W EDGEWOOD DR
Practice Address - Street 2:SUITE D
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5869
Practice Address - Country:US
Practice Address - Phone:573-761-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017006160363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner