Healthcare Provider Details

I. General information

NPI: 1083768022
Provider Name (Legal Business Name): GERALDYNE ANN JOHNSON RN, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 DARNALL LOOP C R DARNALL ARMY MEDICAL CENTER
FORT HOOD TX
76544
US

IV. Provider business mailing address

2900 ELMER KING RD
BELTON TX
76513-7558
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8400
  • Fax:
Mailing address:
  • Phone: 254-933-9301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number444687
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: