Provider Demographics
NPI:1316259294
Name:GERVING, CARRIE (NP)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:GERVING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 NORTH 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58506-5505
Mailing Address - Country:US
Mailing Address - Phone:701-323-5587
Mailing Address - Fax:
Practice Address - Street 1:222 NORTH 7TH STREET
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58506-5505
Practice Address - Country:US
Practice Address - Phone:701-323-5587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR26301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily