MEDICARE: MS. GENEVA KAPLAN ATC

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1316182827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GENEVA KAPLAN ATC

Provider Business Mailing Address
First Line	:	6422 WAGONS EAST TRL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-6707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6422 WAGONS EAST TRL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-6707
Country	:	US
Telephone Number	:	575-639-2007
Fax Number	:

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

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	12/11/2008

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