Healthcare Provider Details

I. General information

NPI: 1992890867
Provider Name (Legal Business Name): JANET GOBROGGE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3763 EDDISHIRE RD
AKRON OH
44319-3825
US

IV. Provider business mailing address

3763 EDDISHIRE RD
AKRON OH
44319-3825
US

V. Phone/Fax

Practice location:
  • Phone: 330-697-8845
  • Fax: 330-836-7704
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP-10445
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN-202618
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: