MEDICARE: PAIGE GIESKE

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1912540998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE GIESKE

Provider Business Mailing Address
First Line	:	12274 GAINES WAY
Second Line	:
City	:	WALTON
State	:	KY
Zip	:	41094-9354
Country	:	US
Telephone Number	:	859-486-7585
Fax Number	:

Provider Business Practice Location Address
First Line	:	2990 RIGGS RD
Second Line	:
City	:	ERLANGER
State	:	KY
Zip	:	41018-3029
Country	:	US
Telephone Number	:	859-727-6700
Fax Number	:

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

Provider Enumeration Date	:	10/23/2019
Last Update Date	:	10/23/2019

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Directions to “ PAIGE GIESKE ” Practice Location

Language	Start Address	Practice Location

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