Healthcare Provider Details

I. General information

NPI: 1528208972
Provider Name (Legal Business Name): HEATHER C GEHRKE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

5228 W PLANO PKWY
PLANO TX
75093-5005
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-4900
  • Fax:
Mailing address:
  • Phone: 972-250-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9121602
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA053761
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: