Provider Demographics
NPI:1447896840
Name:GERHARDT, KACI HINSON (NP)
Entity type:Individual
Prefix:MS
First Name:KACI
Middle Name:HINSON
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2576 ELIZABETH PL
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2414
Mailing Address - Country:US
Mailing Address - Phone:478-954-0968
Mailing Address - Fax:
Practice Address - Street 1:2576 ELIZABETH PL
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2414
Practice Address - Country:US
Practice Address - Phone:478-954-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN196699163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics