Provider Demographics
NPI:1962243675
Name:GEORGI, ANNALIESE MARIE
Entity type:Individual
Prefix:
First Name:ANNALIESE
Middle Name:MARIE
Last Name:GEORGI
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 1:6346 BLUE HERON LN
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4384
Mailing Address - Country:US
Mailing Address - Phone:540-222-7794
Mailing Address - Fax:
Practice Address - Street 1:6346 BLUE HERON LN
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-4384
Practice Address - Country:US
Practice Address - Phone:540-222-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program