Individual
CORAL GERDTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
300 UTAH ST, HIAWATHA, KS 66434-2314
(785) 742-2131
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-0311
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100369010A
—
KS
01
—
114052
BLUE CROSS OF KS
KS
01
—
25014
BLUE CROSS
NE
Enumeration date
07/13/2006
Last updated
12/07/2020
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