Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW60473671 | WA |
NPI | 1124434493 |
---|---|
Provider Name | Neva Anne Gerke |
First Address | Puyallup, WA 98372-3256 |
Second Address | Puyallup, WA 98372-3256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2044222 | (05) | WA |