Provider Demographics
NPI:1154329654
Name:GEIS, JOYCE ANNETTE (FNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANNETTE
Last Name:GEIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:ANNETTE
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1116
Mailing Address - Country:US
Mailing Address - Phone:765-932-4111
Mailing Address - Fax:765-932-7062
Practice Address - Street 1:201 CONRAD HARCOURT WAY
Practice Address - Street 2:SUITE A
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1116
Practice Address - Country:US
Practice Address - Phone:765-932-7591
Practice Address - Fax:765-932-7576
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000958363LF0000X
IN71000958A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300029299Medicaid