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General NPI Number Information
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NPI Number | 1265778047
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Entity Type | Individual
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Provider Name | TANYA S GERACI APRN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2012
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 8013 NEW LA GRANGE RD SUITE 5
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City | LOUISVILLE
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State | KY
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Zip | 40222-4700
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Country | US
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Telephone | 502-434-7050
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Fax | 844-223-9413
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Provider Business Mailing Address
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Address Line | 8013 NEW LA GRANGE RD SUITE 5
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City | LOUISVILLE
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State | KY
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Zip | 40222-4700
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Country | US
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Telephone | 502-434-7050
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Fax | 844-223-9413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3007544
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License Number State | KY
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