Provider Demographics
NPI:1497745327
Name:EARWOOD, GERALDINE STUMP (CRNP)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:STUMP
Last Name:EARWOOD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 LINN DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4248
Mailing Address - Country:US
Mailing Address - Phone:337-531-3723
Mailing Address - Fax:337-531-3100
Practice Address - Street 1:1585 3RD ST
Practice Address - Street 2:INTERNAL MEDICINE CLINIC
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-3723
Practice Address - Fax:337-531-3100
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003477B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily