MEDICARE: ERIN GEARY RN, MS, NNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LN0000X	Neonatal Nurse Practitioner	687554	TX

General Provider Information

NPI Number	:	1205198462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN GEARY RN, MS, NNP-BC

Provider Business Mailing Address
First Line	:	3347 BLACKBURN ST
Second Line	:	APT 10203
City	:	DALLAS
State	:	TX
Zip	:	75204-1536
Country	:	US
Telephone Number	:	917-710-2058
Fax Number	:

Provider Business Practice Location Address
First Line	:	3347 BLACKBURN ST
Second Line	:	APT 10203
City	:	DALLAS
State	:	TX
Zip	:	75204-1536
Country	:	US
Telephone Number	:	917-710-2058
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/13/2012

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