Provider Demographics
NPI:1316202773
Name:BEUGELMANS, GEETAL ADA (RN)
Entity Type:Individual
Prefix:
First Name:GEETAL
Middle Name:ADA
Last Name:BEUGELMANS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 137
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-0137
Mailing Address - Country:US
Mailing Address - Phone:650-281-8512
Mailing Address - Fax:
Practice Address - Street 1:1405 DENMARK ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-9607
Practice Address - Country:US
Practice Address - Phone:650-281-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595736163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse