Individual
SHERI WELLBORN GERSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN077439
LA
363L00000X
Nurse Practitioner
Primary
AP03909
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902128
—
LA
01
—
3D091F600
MEDICARE - PTAN
LA
Enumeration date
02/02/2009
Last updated
08/28/2013
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