Provider Demographics
NPI:1760663132
Name:GERMUNSON, GEORGIA DAYLENE
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:DAYLENE
Last Name:GERMUNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 GLACIER HWY
Mailing Address - Street 2:SUITE 108 B
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8087
Mailing Address - Country:US
Mailing Address - Phone:907-790-3650
Mailing Address - Fax:
Practice Address - Street 1:8800 GLACIER HWY
Practice Address - Street 2:SUITE 108 B
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8087
Practice Address - Country:US
Practice Address - Phone:907-790-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator