Provider Demographics
NPI:1447504303
Name:WOODS, GERALDINE NICOLE (RN)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:NICOLE
Last Name:WOODS
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 1:2034 RAVENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-1507
Mailing Address - Country:US
Mailing Address - Phone:610-633-0342
Mailing Address - Fax:
Practice Address - Street 1:1930 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2328
Practice Address - Country:US
Practice Address - Phone:215-339-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN593437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse