Provider Demographics
NPI:1598353146
Name:GIPSON, TASHA L (RN, BSN, CPN)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:L
Last Name:GIPSON
Suffix:
Gender:F
Credentials:RN, BSN, CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 PLUMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1092
Mailing Address - Country:US
Mailing Address - Phone:513-374-2454
Mailing Address - Fax:
Practice Address - Street 1:10155 KINGSPORT DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-3140
Practice Address - Country:US
Practice Address - Phone:513-374-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36191163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics