Healthcare Provider Details

I. General information

NPI: 1346242526
Provider Name (Legal Business Name): GERALDINE ANN PATTERSON EASTERDAY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CHERISH DR
CAMP HILL PA
17011-1025
US

IV. Provider business mailing address

18 CHERISH DR
CAMP HILL PA
17011-1025
US

V. Phone/Fax

Practice location:
  • Phone: 717-975-2563
  • Fax: 717-975-2585
Mailing address:
  • Phone: 717-975-2563
  • Fax: 717-975-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberRN159069L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: