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Individual
MS. LISA RAE GERGEN
Active
Individual
MS. LISA RAE GERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003813
KY
363LF0000X
Family Nurse Practitioner
1067394
KY
363LF0000X
Family Nurse Practitioner
RN-232372
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000248062
ANTHEM
—
01
—
2442191
UHC
—
05
—
2535028
—
OH
01
—
500027765
MEDICARE RR
—
05
—
78008083
—
KY
01
—
P65717
UPIN
—
Enumeration date
08/26/2005
Last updated
02/03/2016
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