Provider Demographics
NPI:1891029492
Name:GERSH, ANDREA (FNP-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GERSH
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 1:1 BOSTON PL
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4407
Mailing Address - Country:US
Mailing Address - Phone:617-792-6855
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4407
Practice Address - Country:US
Practice Address - Phone:617-792-6855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX862597163W00000X
TXAP134590363LF0000X
CANPF95009279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse