Healthcare Provider Details

I. General information

NPI: 1023609617
Provider Name (Legal Business Name): KELSI NIKOLE GERDEMAN FNP-C, ENP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSI LAUER

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 N MAIN ST
SPRINGBORO OH
45066-9553
US

IV. Provider business mailing address

1316 AMELIA AVE
FINDLAY OH
45840-6504
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-5066
  • Fax: 937-550-9797
Mailing address:
  • Phone: 740-251-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0028380
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: