Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP019646 | PA |
NPI | 1033680772 |
---|---|
Provider Name | Carlin Rose Gerba |
First Address | Washington, PA 15301-3230 |
Second Address | Washington, PA 15301-3336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2018 |
Last Update Date | 06/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018072398 | ANCC (01) | |
SP019646 | CERTIFIED REGISTERED NURSE PRACTITIONER (01) | PA |