Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | B309898 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | B309898 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | B309898 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | B309898 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | B309898 | CA |
NPI | 1225128465 |
---|---|
Provider Name | Ms. Geraldine Marie Collins-Bride |
First Address | San Francisco, CA 94143-0608 |
Second Address | San Francisco, CA 94143-0608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S75168 | (02) | CA |