Individual
MRS. GERALDINE S PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 KANE ST, WEST HARTFORD, CT 06119-2110
(860) 523-3745
(860) 523-6736
Mailing address
342 HIDDEN LAKE ROAD, HIGGANUM, CT 06441
(860) 301-0120
(860) 679-4531
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
002804
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002804
APRN LICENSE
CT
05
—
004236015
—
CT
01
—
1952380842
MEDICAID # FOR UMG
CT
01
—
R34692
REGISTERED NURSE
CT
Enumeration date
01/10/2006
Last updated
05/14/2013
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