Provider Demographics
NPI:1174858021
Name:GIDDENS, TRICIA ELAINE (RN)
Entity Type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:ELAINE
Last Name:GIDDENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:600 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2633
Mailing Address - Country:US
Mailing Address - Phone:740-751-6380
Mailing Address - Fax:
Practice Address - Street 1:270 STERKEL BLVD STE A
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1508
Practice Address - Country:US
Practice Address - Phone:419-525-6737
Practice Address - Fax:419-525-6723
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020524363LF0000X
OHRN.326111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse