Healthcare Provider Details

I. General information

NPI: 1093892341
Provider Name (Legal Business Name): BARBARA JOY GESSNER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 KENMOOR AVE SE STE B
GRAND RAPIDS MI
49546-2391
US

IV. Provider business mailing address

3298 DEPT
CAROL STREAM IL
60122-0021
US

V. Phone/Fax

Practice location:
  • Phone: 616-954-1895
  • Fax: 616-954-2093
Mailing address:
  • Phone: 561-478-8770
  • Fax: 561-598-7231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1601000231
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: