1417991589 NPI number — MRS. EMILY JEAN GEIMAN CNM

Table of content: MRS. EMILY JEAN GEIMAN CNM (NPI 1417991589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417991589 NPI number — MRS. EMILY JEAN GEIMAN CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEIMAN
Provider First Name:
EMILY
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOSER
Provider Other First Name:
EMILY
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417991589
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 SOUTH SECOND STREET
Provider Second Line Business Mailing Address:
SUITE 2F
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17104-1612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LEMOYNE SQ
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-737-4511
Provider Business Practice Location Address Fax Number:
717-909-6659
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  MW010117 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103112881001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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