Provider Demographics
NPI:1689454407
Name:CHRISTENSEN-GERACI, MANDY (DNP)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:CHRISTENSEN-GERACI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15617 AFTON BLVD S
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:MN
Mailing Address - Zip Code:55001-9387
Mailing Address - Country:US
Mailing Address - Phone:715-223-7165
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-672-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10830363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care