Provider Demographics
NPI:1033983184
Name:STOKES, GEORGEANNA
Entity Type:Individual
Prefix:
First Name:GEORGEANNA
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 KIRK AVE APT C7
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-2880
Mailing Address - Country:US
Mailing Address - Phone:662-647-7546
Mailing Address - Fax:
Practice Address - Street 1:101 KIRK AVE APT C7
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-2880
Practice Address - Country:US
Practice Address - Phone:901-443-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver