Provider Demographics
NPI:1952553240
Name:GEER, KIM L (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:L
Last Name:GEER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10279 AMELIA RD
Mailing Address - Street 2:
Mailing Address - City:PITTSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54466-9710
Mailing Address - Country:US
Mailing Address - Phone:715-884-6109
Mailing Address - Fax:
Practice Address - Street 1:10279 AMELIA RD
Practice Address - Street 2:
Practice Address - City:PITTSVILLE
Practice Address - State:WI
Practice Address - Zip Code:54466-9710
Practice Address - Country:US
Practice Address - Phone:715-884-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI169158-030163W00000X
WI310343-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse