Healthcare Provider Details

I. General information

NPI: 1801804422
Provider Name (Legal Business Name): BARBARA GERSHAN ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BLOOMINGTON AVE S COMMUNITY-UNIVERSITY HEALTH CARE CENTER
MINNEAPOLIS MN
55404-3074
US

IV. Provider business mailing address

2001 BLOOMINGTON AVE
MINNEAPOLIS MN
55404-3074
US

V. Phone/Fax

Practice location:
  • Phone: 612-301-3433
  • Fax: 612-627-4205
Mailing address:
  • Phone: 612-301-3433
  • Fax: 612-627-4205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR082832-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: