Provider Demographics
NPI:1265187660
Name:GIBSON, RHONDA LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 STATE ROUTE 133
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:OH
Mailing Address - Zip Code:45106-9415
Mailing Address - Country:US
Mailing Address - Phone:513-638-5916
Mailing Address - Fax:
Practice Address - Street 1:217 HUGHES BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8356
Practice Address - Country:US
Practice Address - Phone:937-386-6942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty