Healthcare Provider Details

I. General information

NPI: 1174364426
Provider Name (Legal Business Name): JOSHUA GEIBE PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 ENGLE RD STE 102
FORT WAYNE IN
46804-2234
US

IV. Provider business mailing address

7230 ENGLE RD STE 102
FORT WAYNE IN
46804-2234
US

V. Phone/Fax

Practice location:
  • Phone: 260-888-1378
  • Fax: 260-387-6763
Mailing address:
  • Phone: 260-888-1378
  • Fax: 260-387-6763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71015352A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: