Provider Demographics
NPI:1285744292
Name:GERLACH, JANE E (CNM MS)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:E
Last Name:GERLACH
Suffix:
Gender:F
Credentials:CNM MS
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 UNION STREET
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-664-5304
Mailing Address - Fax:207-664-5305
Practice Address - Street 1:50 UNION STREET
Practice Address - Street 2:SUITE 3200
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-664-5650
Practice Address - Fax:207-664-5651
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME307700099Medicaid
ME001395702Medicare PIN
ME001395701Medicare PIN
G92437Medicare UPIN