Basic Information
Provider Information
NPI: 1700182508
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEIGER
FirstName: NICOLE
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 UNIVERSITY AVE
Address2:  
City: DES MOINES
State: IA
PostalCode: 503142329
CountryCode: US
TelephoneNumber: 5156977982
FaxNumber: 5152889109
Practice Location
Address1: 1111 UNIVERSITY AVE
Address2:  
City: DES MOINES
State: IA
PostalCode: 503142329
CountryCode: US
TelephoneNumber: 5156977982
FaxNumber: 5152889109
Other Information
ProviderEnumerationDate: 01/27/2011
LastUpdateDate: 01/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X06610IAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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