Provider Demographics
NPI:1699574087
Name:GERKEN, KELLY (DOULA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:GERKEN
Suffix:
Gender:
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S STEARNS AVE
Mailing Address - Street 2:
Mailing Address - City:DESHLER
Mailing Address - State:OH
Mailing Address - Zip Code:43516-1320
Mailing Address - Country:US
Mailing Address - Phone:419-278-7640
Mailing Address - Fax:
Practice Address - Street 1:407 S STEARNS AVE
Practice Address - Street 2:
Practice Address - City:DESHLER
Practice Address - State:OH
Practice Address - Zip Code:43516-1320
Practice Address - Country:US
Practice Address - Phone:419-278-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula