Provider Demographics
NPI:1407425994
Name:GEESAMAN, LORI (CNP-BC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:GEESAMAN
Suffix:
Gender:F
Credentials:CNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1083 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45390-8633
Mailing Address - Country:US
Mailing Address - Phone:937-423-2571
Mailing Address - Fax:
Practice Address - Street 1:820 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1206
Practice Address - Country:US
Practice Address - Phone:937-548-5365
Practice Address - Fax:937-548-4456
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00037336363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health