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NPI Code Detail

MEDICARE: CAROLE GERBER

MEDICARE: CAROLE GERBER
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
1124Q00000XDental HygienistH4645MN

General Provider Information

NPI Number : 1669930442
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE GERBER
Provider Business Mailing Address
First Line : 478 ROBERT ST S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2236
Country : US
Telephone Number : 651-303-1429
Fax Number :
Provider Business Practice Location Address
First Line : 478 ROBERT ST S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2236
Country : US
Telephone Number : 651-303-1429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2019
Last Update Date : 03/11/2019

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Directions to “ CAROLE GERBER ” Practice Location

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