Mrs. Geralyn Sue Prullage
Nurse Practitioner - Neonatal Nurse Practitioner - Neonatal (Critical Care)
415 N 9th St Ste 4w16
Springfield
, Illinois 62702-5303
Mrs. Geralyn Sue Prullage
Nurse Practitioner - Neonatal Nurse Practitioner - Neonatal (Critical Care)
415 N 9th St Ste 4w16
Springfield
, Illinois 62702-5303
(217) 545-8000
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About
Features
Specialties
- Nurse Practitioner - Neonatal
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Mrs. Geralyn Sue Prullage
- 201 E Madison St Ste 328
- Springfield, IL
- Zip : 62702-5131
- Phone : (217) 545-8000
Second Address
- Mrs. Geralyn Sue Prullage
- 415 N 9th St Ste 4w16
- Springfield, IL
- Zip : 62702-5303
- Phone : (217) 545-8000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0000X | Nurse Practitioner - Neonatal | 209008472 | IL |
| N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 041207587 | IL |
National Provider Identifier
| NPI | 1164723656 |
|---|---|
| Provider Name | Mrs. Geralyn Sue Prullage |
| First Address | Springfield, IL 62702-5131 |
| Second Address | Springfield, IL 62702-5303 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/11/2010 |
| Last Update Date | 28/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.