Provider Demographics
NPI:1417286626
Name:GOTTMANN, RHONDA R (CNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:R
Last Name:GOTTMANN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2273
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:71 E HOLLISTER ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1703
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-751-1840
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11255NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200975140Medicaid
KY7100112250Medicaid
OH3043174Medicaid
OHNP33741Medicare PIN