Provider Demographics
NPI:1972087161
Name:GEROSKI, DANIELLE R (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:R
Last Name:GEROSKI
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 HUFFMAN RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:OH
Mailing Address - Zip Code:43451-9739
Mailing Address - Country:US
Mailing Address - Phone:419-619-9550
Mailing Address - Fax:
Practice Address - Street 1:9900 HUFFMAN RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:OH
Practice Address - Zip Code:43451-9739
Practice Address - Country:US
Practice Address - Phone:419-619-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00025469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily