Provider Demographics
NPI:1407163629
Name:DIBLE, THERESA L (APRN-CNP, MS)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:DIBLE
Suffix:
Gender:F
Credentials:APRN-CNP, MS
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2076
Mailing Address - Fax:614-366-0094
Practice Address - Street 1:1800 ZOLLINGER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2849
Practice Address - Country:US
Practice Address - Phone:614-293-2076
Practice Address - Fax:614-366-0094
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17406363L00000X, 363L00000X
OHCOA.17406-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner