Provider Demographics
NPI:1871879015
Name:GERACI, CHRISTY M (PNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:M
Last Name:GERACI
Suffix:
Gender:F
Credentials:PNP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8057
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-454-2810
Mailing Address - Fax:314-454-2818
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2810
Practice Address - Fax:314-454-2818
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011035999363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid