Doctor Name: | GENEVIEVE WASIL-RAYMOND |
NPI Number: | 1649270463 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | VP004208B |
Business Practice Address: | 225 Keystone Ave Cresson, PA - 166301214 |
Business Phone Number: | 8148864635 |
Business Fax Number: | 8148865470 |
Mailing Address: | 1086 Franklin St, JOHNSTOWN |
State: | PA |
Postal Code: | 159054305 |
Phone Number: | 8144108300 |
Fax Number: | 8144108344 |
NPI Enumeration Date: | 07/22/2005 |
NPI Last Update Date: | 09/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | VP004208B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |