Individual
MARK A GERDESMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26846
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
3007284
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01065071
RR MEDICARE
KY
Enumeration date
01/12/2012
Last updated
09/22/2022
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