Provider Demographics
NPI:1043503782
Name:GEISERT, GERLYNDA DIANE (RN)
Entity type:Individual
Prefix:MRS
First Name:GERLYNDA
Middle Name:DIANE
Last Name:GEISERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S WADSWORTH BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3246
Mailing Address - Country:US
Mailing Address - Phone:720-962-4555
Mailing Address - Fax:303-716-7882
Practice Address - Street 1:2525 S WADSWORTH BLVD STE 303
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3246
Practice Address - Country:US
Practice Address - Phone:720-962-4555
Practice Address - Fax:303-716-7882
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse