Provider Demographics
NPI:1053742114
Name:GERSHEL, CAROL (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:GERSHEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 771772
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-1772
Mailing Address - Country:US
Mailing Address - Phone:907-274-9099
Mailing Address - Fax:907-274-8408
Practice Address - Street 1:17141 BARONOFF AVE
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-8139
Practice Address - Country:US
Practice Address - Phone:907-696-2233
Practice Address - Fax:907-274-8408
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK15061373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist