Provider Demographics
NPI:1487900957
Name:GERSTNER-NORRIS, HOLLY BERNADINE (MS, LAT, ATC, PES)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:BERNADINE
Last Name:GERSTNER-NORRIS
Suffix:
Gender:F
Credentials:MS, LAT, ATC, PES
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:BERNADINE
Other - Last Name:GERSTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:219 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-2527
Mailing Address - Country:US
Mailing Address - Phone:608-692-4479
Mailing Address - Fax:
Practice Address - Street 1:300 TWINING ST BLDG 760
Practice Address - Street 2:
Practice Address - City:MAXWELL AFB
Practice Address - State:AL
Practice Address - Zip Code:36112-6027
Practice Address - Country:US
Practice Address - Phone:608-692-4479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1025-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer