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NPI Code Detail

MEDICARE: JENNIFER GEBHART RN

MEDICARE: JENNIFER GEBHART RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN438265OH

General Provider Information

NPI Number : 1720645583
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER GEBHART RN
Provider Business Mailing Address
First Line : 3218 PENNYROYAL RD
Second Line :
City : FRANKLIN
State : OH
Zip : 45005-1011
Country : US
Telephone Number : 937-623-1097
Fax Number :
Provider Business Practice Location Address
First Line : 220 S BREIEL BLVD
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-5106
Country : US
Telephone Number : 385-202-6167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2019
Last Update Date : 05/28/2019

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