Individual
JEAN WADHAMS GELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3152 N MILLBROOK AVE, SUITE B, FRESNO, CA 93703-1459
(559) 244-0133
(559) 244-0148
Mailing address
3812 N 1ST ST, FRESNO, CA 93726-4301
(559) 495-3120
(559) 495-3134
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
275340
CA
363AM0700X
Medical Physician Assistant
5681
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275340
REGISTERED NURSE
CA
01
—
5681
NURSE PRACTITIONER LIC
CA
Enumeration date
01/03/2006
Last updated
12/31/2013
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