Provider Demographics
NPI:1679235808
Name:IBE, GEOFF ROSS (FNP-BC)
Entity type:Individual
Prefix:
First Name:GEOFF
Middle Name:ROSS
Last Name:IBE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16772 W BELL RD STE 110-619
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9702
Mailing Address - Country:US
Mailing Address - Phone:480-388-7084
Mailing Address - Fax:480-741-9545
Practice Address - Street 1:16772 W BELL RD STE 110-619
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9702
Practice Address - Country:US
Practice Address - Phone:480-388-7084
Practice Address - Fax:480-741-9545
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ265209363LP2300X, 363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics