Provider Demographics
NPI:1679891105
Name:GEDZAH, MONET JEANETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:MONET
Middle Name:JEANETTE
Last Name:GEDZAH
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 1:923 KEYSTONE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-1723
Mailing Address - Country:US
Mailing Address - Phone:814-792-9670
Mailing Address - Fax:
Practice Address - Street 1:923 KEYSTONE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-1723
Practice Address - Country:US
Practice Address - Phone:814-792-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN669483163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty