Healthcare Provider Details

I. General information

NPI: 1588190680
Provider Name (Legal Business Name): LAUREN-NICOLE GEIB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 MEDICAL CENTER DR 2301 VUH
NASHVILLE TN
37232-7237
US

IV. Provider business mailing address

2341 MCCALLIE AVE PLAZA 3, SUITE 402
CHATTANOOGA TN
37404
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-1830
  • Fax: 615-936-3412
Mailing address:
  • Phone: 423-648-2720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number58602
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: