Provider Demographics
NPI:1417665613
Name:GERIATRIC PROFESSIONAL SERVICES LLC
Entity Type:Organization
Organization Name:GERIATRIC PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMERICO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:985-256-5599
Mailing Address - Street 1:532 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-4915
Mailing Address - Country:US
Mailing Address - Phone:985-256-5599
Mailing Address - Fax:988-256-5687
Practice Address - Street 1:532 PARK AVE
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-4915
Practice Address - Country:US
Practice Address - Phone:985-256-5599
Practice Address - Fax:988-256-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty