Basic Information
| Provider Information | |||||||||
| NPI: | 1194381723 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEELS | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | BETH | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 243 1/2 W 11TH ST | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494233209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164466919 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1675 LEAHY ST STE 103 | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494425538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317371335 | ||||||||
| FaxNumber: | 2317336801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 10/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 5601009014 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 207Q00000X | 5601009014 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1194381723 | 05 | MI | MEDICAID |