Provider Demographics
NPI:1487474201
Name:GERARDO, EMILY BETH (FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BETH
Last Name:GERARDO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 N MESCALERO DR
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-2060
Mailing Address - Country:US
Mailing Address - Phone:207-671-6697
Mailing Address - Fax:
Practice Address - Street 1:800 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1961
Practice Address - Country:US
Practice Address - Phone:575-894-2111
Practice Address - Fax:575-894-7659
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN82004363LF0000X
NM82004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily