Provider Demographics
NPI:1235966367
Name:NEVILLS, GENEVA MARIE
Entity type:Individual
Prefix:MRS
First Name:GENEVA
Middle Name:MARIE
Last Name:NEVILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MISTY SAILS
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-0078
Mailing Address - Country:US
Mailing Address - Phone:619-750-4781
Mailing Address - Fax:
Practice Address - Street 1:17440 HENDERSON PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1662
Practice Address - Country:US
Practice Address - Phone:210-483-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1044575163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult