Provider Demographics
NPI:1992236012
Name:GERHARDT, ALANNA
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 411
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2323
Mailing Address - Country:US
Mailing Address - Phone:570-501-6368
Mailing Address - Fax:570-501-4754
Practice Address - Street 1:179 INDEPENDENCE RD STE 103
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-9207
Practice Address - Country:US
Practice Address - Phone:570-426-2330
Practice Address - Fax:570-426-2331
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017148363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP017148OtherSTATE LICENSE