Provider Demographics
NPI:1083632616
Name:GEARY, TINA (MSN,ARNP-C)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:GEARY
Suffix:
Gender:
Credentials:MSN,ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 ERIN DR
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9301
Mailing Address - Country:US
Mailing Address - Phone:812-989-7649
Mailing Address - Fax:
Practice Address - Street 1:3122 BLACKISTON MILL RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9501
Practice Address - Country:US
Practice Address - Phone:812-725-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002383A363L00000X
KY3003100363LA2200X
IN71000831363LP0808X
IN71000831A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN129780KMedicare ID - Type Unspecified