Provider Demographics
NPI:1558932046
Name:GEAGA, JOELL EDWARD
Entity Type:Individual
Prefix:
First Name:JOELL
Middle Name:EDWARD
Last Name:GEAGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 DOMINICAN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3337
Mailing Address - Country:US
Mailing Address - Phone:702-462-4255
Mailing Address - Fax:
Practice Address - Street 1:255 DOMINICAN AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-3337
Practice Address - Country:US
Practice Address - Phone:702-462-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide