Provider Demographics
NPI:1972301364
Name:GERDES, ROXANNE JEAN
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:JEAN
Last Name:GERDES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6641 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2019
Mailing Address - Country:US
Mailing Address - Phone:402-580-7839
Mailing Address - Fax:
Practice Address - Street 1:6641 BENTON ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-2019
Practice Address - Country:US
Practice Address - Phone:402-580-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider