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General NPI Number Information
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NPI Number | 1720302870
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Entity Type | Individual
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Provider Name | JOEY L GERHARDT CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 920 STANTON L YOUNG BLVD STE 1140
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5036
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Country | US
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Telephone | 405-271-4351
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Fax |
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Provider Business Mailing Address
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Address Line | 17572 KAITLYN DR
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City | BATON ROUGE
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State | LA
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Zip | 70817-7463
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Country | US
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Telephone | 225-802-9427
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11013111
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R0101839
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN094700 AP06023
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License Number State | LA
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