1790841039 NPI number — MARNIE A GEIGER CRNA

Table of content: MARNIE A GEIGER CRNA (NPI 1790841039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790841039 NPI number — MARNIE A GEIGER CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEIGER
Provider First Name:
MARNIE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEBER
Provider Other First Name:
MARNIE
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790841039
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 WOODLAND PRIME
Provider Second Line Business Mailing Address:
N74W12501 LEATHERWOOD CT SUITE 103
Provider Business Mailing Address City Name:
MENOMONEE FALLS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53051-4477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-777-1031
Provider Business Mailing Address Fax Number:
414-777-0033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 WOODLAND PRIME
Provider Second Line Business Practice Location Address:
N74W12501 LEATHERWOOD CT SUITE 103
Provider Business Practice Location Address City Name:
MENOMONEE FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53051-4477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-777-1031
Provider Business Practice Location Address Fax Number:
414-777-0033
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  122256-030 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44359500 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com