MEDICARE: MARY ELIZABETH GEROW PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5018660	NC

General Provider Information

NPI Number	:	1558145805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH GEROW PMHNP

Provider Business Mailing Address
First Line	:	13251 FALLS OF NEUSE RD STE 121
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-8573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13251 FALLS OF NEUSE RD STE 121
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-8573
Country	:	US
Telephone Number	:	919-785-5055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2023
Last Update Date	:	08/18/2023

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