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General NPI Number Information
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NPI Number | 1861701666
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Entity Type | Individual
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Provider Name | KRISTEN MARIE GERAGHTY R.N., N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | UCLA MEDL CNTR ONCOLOGY CNTR BOWYER CLINIC BOX 956956, STE 120, 200 MEDL PLZ
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City | LOS ANGELES
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State | CA
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Zip | 90095-6956
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Country | US
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Telephone | 858-449-8761
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Fax |
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Provider Business Mailing Address
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Address Line | UCLA MEDL CNTR ONCOLOGY CNTR BOWYER CLINIC BOX 956956, STE 120, 200 MEDL PLZ
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City | LOS ANGELES
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State | CA
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Zip | 90095-6956
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Country | US
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Telephone | 858-449-8761
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 19850
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License Number State | CA
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