Healthcare Provider Details

I. General information

NPI: 1770663429
Provider Name (Legal Business Name): CATHERINE THERESA GEHRAU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAG ANSBACH HEALTH CLINIC UNIT 28614
APO AE
09177
DE

IV. Provider business mailing address

CMR 454 BOX 1907
APO AE
09250
DE

V. Phone/Fax

Practice location:
  • Phone: 011499802833
  • Fax:
Mailing address:
  • Phone: 011499802833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number26NO06491900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: