Provider Demographics
NPI:1811932387
Name:GERHARDT, ANNIE MARGARET (APRN-BC, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:MARGARET
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:APRN-BC, PMHNP-BC
Other - Prefix:MISS
Other - First Name:ANNIE
Other - Middle Name:MARGARET
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13780
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58208
Mailing Address - Country:US
Mailing Address - Phone:701-662-2157
Mailing Address - Fax:701-662-4116
Practice Address - Street 1:1001 7TH STREET NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-1100
Practice Address - Country:US
Practice Address - Phone:701-662-2157
Practice Address - Fax:701-662-4116
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR27319363L00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19743Medicaid
NDP00046239OtherRR MEDICARE
NDP00046239OtherRR MEDICARE
NDP92488Medicare UPIN