Provider Demographics
NPI:1679680631
Name:RIBAR, ALICIA K (CNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:K
Last Name:RIBAR
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:L-3401
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-3401
Mailing Address - Country:US
Mailing Address - Phone:740-615-1324
Mailing Address - Fax:740-615-1344
Practice Address - Street 1:4141 N. HAMPTON DR
Practice Address - Street 2:SUITE 103
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7062
Practice Address - Country:US
Practice Address - Phone:740-615-2800
Practice Address - Fax:740-615-2801
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-050443747A0650X
OHNP05044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2336298Medicaid
NP04495Medicare PIN
OH2336298Medicaid