MEDICARE: PAMELA S GEOCARIS RN, CPSN, CSFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0121X	Plastic Surgery Registered Nurse	232999-30	WI

General Provider Information

NPI Number	:	1871263038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA S GEOCARIS RN, CPSN, CSFA

Provider Business Mailing Address
First Line	:	1035 KEPLER DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-8320
Country	:	US
Telephone Number	:	920-490-9046
Fax Number	:	920-405-8005

Provider Business Practice Location Address
First Line	:	2605 DEVELOPMENT DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-4240
Country	:	US
Telephone Number	:	920-288-8240
Fax Number	:	920-857-1488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	06/02/2026

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