Organization
TULIP TREE HEALTH SERVICES OF GIBSON COUNTY, INC.
Active
Other names
Tulip Tree Family Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINE M GEORGES (CHIEF EXECUTIVE OFFICER)
(812) 753-1039
Entity
Organization
Contact information
Practice address
123 N MCCREARY ST, FORT BRANCH, IN 47648
(812) 753-1039
(812) 753-1122
Mailing address
108 N MAIN ST, PRINCETON, IN 47670-1540
(812) 753-1039
(812) 753-1122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
207Q00000X
Family Medicine Physician
02000610
IN
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200248220A
—
IN
05
—
300039487A
—
IN
Enumeration date
03/21/2007
Last updated
09/04/2024
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