Provider Demographics
NPI:1447641238
Name:GEMLO, JOHN P (CNP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:GEMLO
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:100 FREEMAN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-3504
Mailing Address - Country:US
Mailing Address - Phone:507-985-2357
Mailing Address - Fax:651-431-7657
Practice Address - Street 1:100 FREEMAN DR
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-3504
Practice Address - Country:US
Practice Address - Phone:507-985-2357
Practice Address - Fax:651-431-7657
Is Sole Proprietor?:No
Enumeration Date:2015-02-15
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 3504363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology