Provider Demographics
NPI:1902093404
Name:BRITTON, GERALDINE ROSE AVIDANO (RN, FNP, PHD)
Entity Type:Individual
Prefix:PROF
First Name:GERALDINE
Middle Name:ROSE AVIDANO
Last Name:BRITTON
Suffix:
Gender:F
Credentials:RN, FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2714
Mailing Address - Country:US
Mailing Address - Phone:607-962-2443
Mailing Address - Fax:607-962-3571
Practice Address - Street 1:25 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1515
Practice Address - Country:US
Practice Address - Phone:570-724-5338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily