MEDICARE: HANNAH BETH GEELS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	5601009014	MI
2	207Q00000X	Family Medicine Physician	5601009014	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194381723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BETH GEELS PA-C

Provider Business Mailing Address
First Line	:	243 1/2 W 11TH ST
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-3209
Country	:	US
Telephone Number	:	616-446-6919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 LEAHY ST STE 103
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-5538
Country	:	US
Telephone Number	:	231-737-1335
Fax Number	:	231-733-6801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	10/16/2019

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Directions to “ HANNAH BETH GEELS PA-C” Practice Location

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