Provider Demographics
NPI:1023010295
Name:BLISS, GERIANNE ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:GERIANNE
Middle Name:ROSE
Last Name:BLISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 SW 260TH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-7593
Mailing Address - Country:US
Mailing Address - Phone:660-422-8699
Mailing Address - Fax:660-422-8697
Practice Address - Street 1:600 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-2621
Practice Address - Country:US
Practice Address - Phone:660-543-4770
Practice Address - Fax:660-543-8222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8G46207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO22201021OtherBCBS
MO22201021OtherBCBS