Provider Demographics
NPI:1386676070
Name:STRAUB, GENEVA H (MSN ARNP CS)
Entity Type:Individual
Prefix:MRS
First Name:GENEVA
Middle Name:H
Last Name:STRAUB
Suffix:
Gender:F
Credentials:MSN ARNP CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 KINGS DAUGHTERS DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4187
Mailing Address - Country:US
Mailing Address - Phone:502-223-7486
Mailing Address - Fax:502-223-7491
Practice Address - Street 1:304 KINGS DAUGHTERS DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4187
Practice Address - Country:US
Practice Address - Phone:502-223-7486
Practice Address - Fax:502-223-7491
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2229S101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CNS0002Medicare ID - Type Unspecified
KYS23868Medicare UPIN