Provider Demographics
NPI:1154691640
Name:GEYER, AMANDA JO (LPN)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JO
Last Name:GEYER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8468 PINE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1965
Mailing Address - Country:US
Mailing Address - Phone:513-254-1397
Mailing Address - Fax:
Practice Address - Street 1:8468 PINE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1965
Practice Address - Country:US
Practice Address - Phone:513-254-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.118196-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse