MEDICARE: MS. PAMELA SUE GIESON RN

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	163W00000X	Registered Nurse	RN136643	MO
2	163W00000X	Registered Nurse	041-294105	IL
3	163W00000X	Registered Nurse	101077	KS

General Provider Information

NPI Number	:	1992947543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA SUE GIESON RN

Provider Business Mailing Address
First Line	:	10820 ROBINSON DR
Second Line	:
City	:	BUNKER HILL
State	:	IL
Zip	:	62014-2809
Country	:	US
Telephone Number	:	314-799-2731
Fax Number	:	314-289-1169

Provider Business Practice Location Address
First Line	:	4050 LINDELL BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-3202
Country	:	US
Telephone Number	:	314-658-2133
Fax Number	:	314-289-1169

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

Provider Enumeration Date	:	03/28/2009
Last Update Date	:	03/28/2009

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