Provider Demographics
NPI:1023274883
Name:GIERHAHN, DEBRA JOY (RN)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JOY
Last Name:GIERHAHN
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 1:2428 N 88TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1956
Mailing Address - Country:US
Mailing Address - Phone:414-453-7877
Mailing Address - Fax:262-786-9486
Practice Address - Street 1:14640 WOODLAND PL
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1112
Practice Address - Country:US
Practice Address - Phone:414-491-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI68118-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35065900Medicaid