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Individual
JODI DANIELLE GERDES
Active
Individual
JODI DANIELLE GERDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
51623
TN
2086S0129X
Vascular Surgery Physician
Primary
71331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6086635
BLUE CROSS BLUE SHIELD
TN
05
—
Q009383
—
TN
Enumeration date
06/12/2007
Last updated
06/15/2022
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