Provider Demographics
NPI:1629321906
Name:GRIBBINS, ASHLEY (CNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GRIBBINS
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-912-7211
Mailing Address - Fax:859-655-8981
Practice Address - Street 1:85 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1793
Practice Address - Country:US
Practice Address - Phone:859-912-7211
Practice Address - Fax:859-655-6674
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1118567363L00000X
OH14010NP363L00000X
KY3007840363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01508009OtherRR MEDICARE
KY7100259550Medicaid
OH0077257Medicaid
OH0077257Medicaid
OHP01263322Medicare PIN
OHH191150Medicare PIN
KYK092080Medicare PIN