Provider Demographics
NPI:1790841039
Name:GEIGER, MARNIE A (CRNA)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:A
Last Name:GEIGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARNIE
Other - Middle Name:A
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:400 WOODLAND PRIME
Mailing Address - Street 2:N74W12501 LEATHERWOOD CT SUITE 103
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4477
Mailing Address - Country:US
Mailing Address - Phone:414-777-1031
Mailing Address - Fax:414-777-0033
Practice Address - Street 1:400 WOODLAND PRIME
Practice Address - Street 2:N74W12501 LEATHERWOOD CT SUITE 103
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-4477
Practice Address - Country:US
Practice Address - Phone:414-777-1031
Practice Address - Fax:414-777-0033
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI122256-030367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44359500Medicaid