Provider Demographics
NPI:1144692054
Name:GEISE, BILLIE JO (FNP)
Entity type:Individual
Prefix:MS
First Name:BILLIE
Middle Name:JO
Last Name:GEISE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0485
Mailing Address - Country:US
Mailing Address - Phone:765-478-4541
Mailing Address - Fax:765-478-4564
Practice Address - Street 1:415 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE CITY
Practice Address - State:IN
Practice Address - Zip Code:47327-1323
Practice Address - Country:US
Practice Address - Phone:765-478-4541
Practice Address - Fax:765-478-4564
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28164057A363LF0000X
IN71005958A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201335670Medicaid