Provider Demographics
NPI:1437478120
Name:ANGLIN, GERALDINE MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:MARY
Last Name:ANGLIN
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 1:3701 PORTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-9179
Mailing Address - Country:US
Mailing Address - Phone:440-213-8073
Mailing Address - Fax:
Practice Address - Street 1:3701 PORTSIDE DR
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-9179
Practice Address - Country:US
Practice Address - Phone:440-213-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN256735163WG0600X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical