Provider Demographics
NPI:1467249268
Name:BRACY, GERALDINE TATLINE
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:TATLINE
Last Name:BRACY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20509 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-2929
Mailing Address - Country:US
Mailing Address - Phone:951-941-0600
Mailing Address - Fax:
Practice Address - Street 1:20509 NATHAN DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-2929
Practice Address - Country:US
Practice Address - Phone:951-941-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula