Individual
MRS. MARY LOUISE GERCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
323 N CALVERT ST, BALTIMORE, MD 21202-3611
(410) 332-9083
Mailing address
1402 MARYWOOD DR, BEL AIR, MD 21014-2015
(410) 908-5509
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R065950
MD
363LP2300X
Primary Care Nurse Practitioner
R065950
MD
364SG0600X
Gerontology Clinical Nurse Specialist
R065950
MD
Other
Enumeration date
07/01/2013
Last updated
07/15/2013
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