Individual
GERALD E NIERNBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14700 W SAINT TERESA ST STE 300, WICHITA, KS 67235-9630
(316) 274-0142
(316) 719-1021
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207Q00000X
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014394
BCBS
KS
05
—
100231520A
—
KS
01
—
100302
HPK
KS
01
—
12149386
MULTIPLAN
KS
01
—
16858
COVENTRY
KS
01
—
681
PHS
KS
Enumeration date
06/30/2006
Last updated
01/09/2023
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