MEDICARE: COLEEN GEARHART NP

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.07395	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.07395	OH
3	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.07395	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00067696	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588601736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLEEN GEARHART NP

Provider Business Mailing Address
First Line	:	230 QUADRAL DR STE B
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-8375
Country	:	US
Telephone Number	:	330-336-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6707 POWERS BLVD STE 106
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-5463
Country	:	US
Telephone Number	:	440-886-2509
Fax Number	:	440-886-2547

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	01/08/2026

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Directions to “ COLEEN GEARHART NP” Practice Location

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