Healthcare Provider Details

I. General information

NPI: 1447944483
Provider Name (Legal Business Name): ALLISON GERGES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVENUE PEDIATRIC HEART CENTER M41
CLEVELAND OH
44195
US

IV. Provider business mailing address

28852 WOODMILL DR
WESTLAKE OH
44145-2090
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-3083
  • Fax:
Mailing address:
  • Phone: 740-590-6465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0033219
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0033219
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: