Provider Demographics
NPI:1598511339
Name:PEARSON, GERALDENA LIZETTE
Entity type:Individual
Prefix:
First Name:GERALDENA
Middle Name:LIZETTE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 CABORA LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-1511
Mailing Address - Country:US
Mailing Address - Phone:614-515-1235
Mailing Address - Fax:
Practice Address - Street 1:1533 CABORA LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-1511
Practice Address - Country:US
Practice Address - Phone:614-515-1235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant