Healthcare Provider Details

I. General information

NPI: 1497479745
Provider Name (Legal Business Name): ALEXANDRIA GERTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 COSHOCTON AVE STE I
MOUNT VERNON OH
43050-1900
US

IV. Provider business mailing address

9 COLONY DR
FREDERICKTOWN OH
43019-1077
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone: 419-560-7146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007201
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: