Organization Name: | GERO-PSYCH NURSING, S.C. |
NPI Number: | 1790794329 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BEVERLY SIGL FELTEN (CEO) |
Mailing Address: | 19822 W Good Hope Rd Lannon |
State: | WI US |
Postal Code: | 530469775 |
Phone Number: | 2622513808 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 4-033 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |