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General NPI Number Information
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NPI Number | 1821746421
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Entity Type | Organization
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Legal Business Name | GERTHY C PIERRE LLC
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Dates
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Enumeration Date | 03/13/2022
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 9 EAGLE CTR
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City | O FALLON
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State | IL
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Zip | 62269-1948
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Country | US
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Telephone | 847-852-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 CLOVERDALE DR
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-5500
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Country | US
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Telephone | 847-852-0145
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | GERTHY CIPUS PIERRE
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Credential | FNP
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Telephone | 847-852-0145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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