Healthcare Provider Details

I. General information

NPI: 1366402539
Provider Name (Legal Business Name): JOANN MARIE GERKIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: MS. JOANN MARIE STEPHENS

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 BOX HILL CORPORATE CENTER DR
ABINGDON MD
21009-1261
US

IV. Provider business mailing address

40 THERESA LN
NORTH EAST MD
21901-3201
US

V. Phone/Fax

Practice location:
  • Phone: 443-402-2695
  • Fax:
Mailing address:
  • Phone: 410-287-7545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberR126597
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: