Provider Demographics
NPI:1336263219
Name:ACCOMAZZO, GERALDINE LOUISE (NP)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:LOUISE
Last Name:ACCOMAZZO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCB 119
Mailing Address - Street 2:UNIVERSITY OF COLORADO, BOULDER CAMPUS
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80309
Mailing Address - Country:US
Mailing Address - Phone:303-492-1960
Mailing Address - Fax:303-735-1800
Practice Address - Street 1:119 UCB
Practice Address - Street 2:UNIVERSITY OF COLORADO, BOULDER CAMPUS
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-5001
Practice Address - Country:US
Practice Address - Phone:303-492-1960
Practice Address - Fax:303-735-1800
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily