| Doctor Name: | GERALDINE STUMP EARWOOD |
| NPI Number: | 1497745327 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | TP003477B |
| Business Practice Address: | 1585 3rd St Internal Medicine Clinic Fort Polk, LA - 714595102 |
| Business Phone Number: | 3375313723 |
| Business Fax Number: | 3375313100 |
| Mailing Address: | 1132 Linn Dr, CARLISLE |
| State: | PA |
| Postal Code: | 170134248 |
| Phone Number: | 3375313723 |
| Fax Number: | 3375313100 |
| NPI Enumeration Date: | 10/22/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | TP003477B |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |