Provider Demographics
NPI:1861707499
Name:GERSCH, KATHRYN E (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:E
Last Name:GERSCH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 MONTGOMERY ST
Mailing Address - Street 2:ONONDAGA COUNTY DEPARTMENT OF HEALTH (ROOM 80)
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2923
Mailing Address - Country:US
Mailing Address - Phone:315-435-3236
Mailing Address - Fax:
Practice Address - Street 1:421 MONTGOMERY ST
Practice Address - Street 2:ONONDAGA COUNTY DEPARTMENT OF HEALTH (ROOM 80)
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2923
Practice Address - Country:US
Practice Address - Phone:315-435-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334967-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily