Provider Demographics
NPI:1801054267
Name:ADVANCED GERIATRIC EDUCATION & CONSULTING,LLC
Entity type:Organization
Organization Name:ADVANCED GERIATRIC EDUCATION & CONSULTING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MS,APRN-BC
Authorized Official - Phone:513-225-6092
Mailing Address - Street 1:9823 TULIP TREE CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-5597
Mailing Address - Country:US
Mailing Address - Phone:513-683-1823
Mailing Address - Fax:
Practice Address - Street 1:9823 TULIP TREE CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-5597
Practice Address - Country:US
Practice Address - Phone:513-683-1823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-01
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-02537363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1710932868OtherPERSONAL NPI
OH1992849509OtherPERSONAL NPI