Provider Demographics
NPI:1114614617
Name:LOUIS-ISMA, GERALDA
Entity Type:Individual
Prefix:
First Name:GERALDA
Middle Name:
Last Name:LOUIS-ISMA
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 1:7 PUSAN RD APT C
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-4159
Mailing Address - Country:US
Mailing Address - Phone:305-560-1186
Mailing Address - Fax:
Practice Address - Street 1:7 PUSAN RD APT C
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-4159
Practice Address - Country:US
Practice Address - Phone:305-560-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2381993163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care