Geertruida Cornelia Disseldorp, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN100092 Issued in GA

Practice address

2660 Osborne Rd NE
Atlanta, GA 30319-2832

Phone

(404) 231-9363

Fax

(404) 231-9569

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dekalb Community Service Board

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1861536955
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114142544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 SHAW DRIVE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665627",
            "telephone_number": "404-231-9363",
            "fax_number": "404-231-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 OSBORNE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303192832",
            "telephone_number": "404-231-9363",
            "fax_number": "404-231-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISSELDORP",
        "first_name": "GEERTRUIDA",
        "middle_name": "CORNELIA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN100092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Disisto, PA-C
• Lindsey L Diskin, CRNA
• Abegail Tate Dismukes
• Dispatchhealth Advanced Care LLC
• Franco Dispenza, PHD
• Distinctive Nature, LLC
• Distinctive Professional Services (DPS)
• Noah Gabriel Ditkofsky, MD FRCPC
• Trenton Pace Dittmer, M.D.
• Dili Priya Divakaran, PT

• Registered Nurse in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.