Provider Demographics
NPI:1194147348
Name:GERRITY, KATY M (LPN)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:M
Last Name:GERRITY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:M
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:135 HARDER PLACE
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895
Mailing Address - Country:US
Mailing Address - Phone:585-808-8250
Mailing Address - Fax:
Practice Address - Street 1:82 OLIVE ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:NY
Practice Address - Zip Code:14715-1310
Practice Address - Country:US
Practice Address - Phone:585-928-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260803-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse