Provider Demographics
NPI:1982384046
Name:ABCEDE, GERALDINE QUINTO (RN)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:QUINTO
Last Name:ABCEDE
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 1:500 ENERGY WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3793
Mailing Address - Country:US
Mailing Address - Phone:817-885-7710
Mailing Address - Fax:
Practice Address - Street 1:500 ENERGY WAY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3793
Practice Address - Country:US
Practice Address - Phone:817-885-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA826196163W00000X
TX1024046367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse