Provider Demographics
NPI:1215086582
Name:KENSINGER, GERTRUDE ERWIN (RN)
Entity type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:ERWIN
Last Name:KENSINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TRUDY
Other - Middle Name:ERWIN
Other - Last Name:KENSINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10214 ELBOW BEND RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10214 ELBOW BEND RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5302
Practice Address - Country:US
Practice Address - Phone:813-671-1187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1443172163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse