MEDICARE: MR. GEOFFREY GEORGE GEPHART FNP-BC

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	363LF0000X	Family Nurse Practitioner	28185645A	IN

General Provider Information

NPI Number	:	1477800829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEOFFREY GEORGE GEPHART FNP-BC

Provider Business Mailing Address
First Line	:	1731 SYCAMORE HILLS DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-9390
Country	:	US
Telephone Number	:	260-625-3693
Fax Number	:

Provider Business Practice Location Address
First Line	:	10012 AUBURN PARK DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2389
Country	:	US
Telephone Number	:	317-644-8457
Fax Number	:

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

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	08/03/2012

Similar Medicare Providers

1447955406 — PREMISE HEALTH OF INDIANA MEDICAL PC
Practice Location Address:

10006 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-247-8020
Practice Fax:

1548203300 — MARK WILLIAM DELBELLO M.D.
Practice Location Address:

10002 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-482-1681
Practice Fax: 260-482-1857

1992097026 — ASSOCIATED SURGEONS AND PHYSICIANS, LLC
Practice Location Address:

10002 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-482-1681
Practice Fax: 260-482-1857

1164860086 — DR. ANDREW J MULLALLY MD
Practice Location Address:

10050 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-432-6459
Practice Fax: 260-240-5284

1407203672 — CREDO HEALTH GROUP, LLC
Practice Location Address:

10050 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-432-6459
Practice Fax: 260-240-5284

1699223289 — HEATHER MARIE RICHARDVILLE DPT
Practice Location Address:

10006 AUBURN PARK DR
FORT WAYNE, IN
46825-2389

Practice Phone: 260-497-7191
Practice Fax: 260-497-7791

Directions to “ MR. GEOFFREY GEORGE GEPHART FNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.