Provider Demographics
NPI:1902448673
Name:GERSTEL, JOHANNE ALONSO (NMD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNE
Middle Name:ALONSO
Last Name:GERSTEL
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E SOUTHERN AVE STE J2
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7742
Mailing Address - Country:US
Mailing Address - Phone:480-584-3224
Mailing Address - Fax:480-681-3946
Practice Address - Street 1:2600 E SOUTHERN AVE STE J2
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7742
Practice Address - Country:US
Practice Address - Phone:480-584-3224
Practice Address - Fax:480-584-3699
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1841175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath