Provider Demographics
NPI:1801670443
Name:GEISTER, CHARLENE FRANCES (LPN)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:FRANCES
Last Name:GEISTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 QUARTZ ISLE DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1525
Mailing Address - Country:US
Mailing Address - Phone:989-501-0593
Mailing Address - Fax:
Practice Address - Street 1:2603 QUARTZ ISLE DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1525
Practice Address - Country:US
Practice Address - Phone:989-501-0593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703094986164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse