Provider Demographics
NPI:1669816062
Name:GEDDES, RITA ANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:ANNE
Last Name:GEDDES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ADIRONDACK LN
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-3201
Mailing Address - Country:US
Mailing Address - Phone:518-565-6347
Mailing Address - Fax:
Practice Address - Street 1:2 ADIRONDACK LN
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3201
Practice Address - Country:US
Practice Address - Phone:518-565-6347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303071164W00000X
NY303071-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse