Provider Demographics
NPI:1427008200
Name:GERIATRIC NURSE PRACTITIONERS, INC.
Entity Type:Organization
Organization Name:GERIATRIC NURSE PRACTITIONERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-666-9544
Mailing Address - Street 1:231 SPRINGSIDE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4530
Mailing Address - Country:US
Mailing Address - Phone:330-666-9544
Mailing Address - Fax:330-670-8569
Practice Address - Street 1:231 SPRINGSIDE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-4530
Practice Address - Country:US
Practice Address - Phone:330-666-9544
Practice Address - Fax:330-670-8569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2457863Medicaid
OH2457863Medicaid