Healthcare Provider Details

I. General information

NPI: 1265366900
Provider Name (Legal Business Name): STEPHANIE GERATHY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 US HIGHWAY 131 UNIT 3
PETOSKEY MI
49770-8344
US

IV. Provider business mailing address

1890 US HIGHWAY 131 UNIT 3
PETOSKEY MI
49770-8344
US

V. Phone/Fax

Practice location:
  • Phone: 231-487-6000
  • Fax:
Mailing address:
  • Phone: 231-487-6000
  • Fax: 231-487-6014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704313126
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: