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NPI Code Detail

MEDICARE: JAMIE LYNNE GERACI MSN, CWON, NP-C

MEDICARE: JAMIE LYNNE GERACI MSN, CWON, NP-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
1363LA2200XAdult Health Nurse PractitionerLE-00037959OH

General Provider Information

NPI Number : 1396411948
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE LYNNE GERACI MSN, CWON, NP-C
Provider Business Mailing Address
First Line : 3690 BRISTOL LAKE DR
Second Line :
City : AMELIA
State : OH
Zip : 45102-2618
Country : US
Telephone Number : 513-504-9210
Fax Number :
Provider Business Practice Location Address
First Line : 375 DIXMYTH AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2489
Country : US
Telephone Number : 513-862-3364
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2021
Last Update Date : 08/23/2021

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