MEDICARE: MRS. DEBRA JOY GIERHAHN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	68118-030	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023274883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA JOY GIERHAHN RN

Provider Business Mailing Address
First Line	:	2428 N 88TH ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-1956
Country	:	US
Telephone Number	:	414-453-7877
Fax Number	:	262-786-9486

Provider Business Practice Location Address
First Line	:	14640 WOODLAND PL
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-1112
Country	:	US
Telephone Number	:	414-491-8101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	07/31/2008

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