Healthcare Provider Details

I. General information

NPI: 1245233287
Provider Name (Legal Business Name): KRISTIE LYNN GERING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 COUNTY HIGHWAY I SUITE 2C
CHIPPEWA FALLS WI
54729
US

IV. Provider business mailing address

2829 COUNTY HIGHWAY I SUITE 2C
CHIPPEWA FALLS WI
54729
US

V. Phone/Fax

Practice location:
  • Phone: 715-860-2300
  • Fax: 715-861-2302
Mailing address:
  • Phone: 715-860-2300
  • Fax: 715-861-2302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39046
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: