Provider Demographics
NPI:1366783482
Name:GERRISH, ASHLEY K (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:GERRISH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:L
Other - Last Name:KERSTETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:LYNDONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05851-0083
Mailing Address - Country:US
Mailing Address - Phone:802-748-9501
Mailing Address - Fax:802-748-3420
Practice Address - Street 1:195 INDUSTRIAL PARKWAY
Practice Address - Street 2:
Practice Address - City:LYNDON
Practice Address - State:VT
Practice Address - Zip Code:05851
Practice Address - Country:US
Practice Address - Phone:802-748-9501
Practice Address - Fax:802-748-3420
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0093677363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology