Healthcare Provider Details

I. General information

NPI: 1982240115
Provider Name (Legal Business Name): GERI ANN MCCARTHY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERI ANN THOMAS ARNP

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 02/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 RING ROAD SUITE 240
ELIZABETHTOWN KY
42701
US

IV. Provider business mailing address

1690 RING ROAD SUITE 240
ELIZABETHTOWN KY
42701
US

V. Phone/Fax

Practice location:
  • Phone: 207-600-3110
  • Fax:
Mailing address:
  • Phone: 207-600-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30134141
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: