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General NPI Number Information
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NPI Number | 1326024688
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Entity Type | Individual
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Provider Name | BETH A GERKAN FNP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 6065 STATE HIGHWAY 193
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City | GEORGETOWN
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State | CA
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Zip | 95634-9623
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Country | US
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Telephone | 530-333-2555
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Fax | 503-333-8232
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Provider Business Mailing Address
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Address Line | PO BOX 45680
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City | SAN FRANCISCO
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State | CA
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Zip | 94145-0680
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Country | US
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Telephone | 530-333-2555
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Fax | 503-333-8232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 417801
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | NP11335
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License Number State | CA
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