Provider Demographics
NPI:1972103232
Name:GERALD, TAUSCHA ALYSE (FNP)
Entity type:Individual
Prefix:MRS
First Name:TAUSCHA
Middle Name:ALYSE
Last Name:GERALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:DR
Other - First Name:TAUSCHA
Other - Middle Name:ALYSE
Other - Last Name:GERALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:13440 NC HIGHWAY 210
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-7725
Mailing Address - Country:US
Mailing Address - Phone:919-207-3086
Mailing Address - Fax:
Practice Address - Street 1:13440 NC HIGHWAY 210
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-7725
Practice Address - Country:US
Practice Address - Phone:919-207-3086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013808363LF0000X
NC0000000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily