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General NPI Number Information
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NPI Number | 1801054267
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Entity Type | Organization
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Legal Business Name | ADVANCED GERIATRIC EDUCATION & CONSULTING,LLC
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Dates
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Enumeration Date | 06/01/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 9823 TULIP TREE CT
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City | LOVELAND
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State | OH
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Zip | 45140-5597
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Country | US
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Telephone | 513-683-1823
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Fax |
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Provider Business Mailing Address
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Address Line | 9823 TULIP TREE CT
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City | LOVELAND
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State | OH
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Zip | 45140-5597
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Country | US
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Telephone | 513-683-1823
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Fax |
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Authorized Official
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Title or Position | GNP
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Name | MRS. PHYLLIS JOY ATKINSON
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Credential | RN,MS,APRN-BC
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Telephone | 513-225-6092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP-02537
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License Number State | OH
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