Provider Demographics
NPI:1043034051
Name:MICLAUS, GETA VERONICA (FNP)
Entity type:Individual
Prefix:
First Name:GETA
Middle Name:VERONICA
Last Name:MICLAUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3430
Mailing Address - Country:US
Mailing Address - Phone:714-726-2808
Mailing Address - Fax:
Practice Address - Street 1:1532 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3430
Practice Address - Country:US
Practice Address - Phone:714-726-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA639782363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care