MEDICARE: WENDY E GEER APRN

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	163WG0000X	General Practice Registered Nurse	1067871	KY
2	363LF0000X	Family Nurse Practitioner	2018P	KY
3	363LF0000X	Family Nurse Practitioner	3002018	KY
4	363L00000X	Nurse Practitioner	3002018	KY

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	:	1659336188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY E GEER APRN

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	1230 MARKET ST
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-7986
Country	:	US
Telephone Number	:	502-225-6900
Fax Number	:	502-666-7693

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	03/17/2018

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