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General NPI Number Information
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NPI Number | 1316925035
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Entity Type | Individual
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Provider Name | JEAN WADHAMS GELLER NP
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Gender | Female
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 3152 N MILLBROOK AVE SUITE B
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City | FRESNO
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State | CA
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Zip | 93703-1459
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Country | US
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Telephone | 559-244-0133
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Fax | 559-244-0148
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Provider Business Mailing Address
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Address Line | 3812 N 1ST ST
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City | FRESNO
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State | CA
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Zip | 93726-4301
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Country | US
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Telephone | 559-495-3120
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Fax | 559-495-3134
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | 275340
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5681
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License Number State | CA
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