Healthcare Provider Details

I. General information

NPI: 1275768061
Provider Name (Legal Business Name): GAYLYN J HOSMER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 COLUMBUS ROAD
ATHENS OH
45701-1315
US

IV. Provider business mailing address

141 COLUMBUS ROAD
ATHENS OH
45701-1315
US

V. Phone/Fax

Practice location:
  • Phone: 740-592-4229
  • Fax: 740-592-4010
Mailing address:
  • Phone: 740-592-4229
  • Fax: 740-592-4010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA-00271-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334902-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA 00271 NP
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCOA-00271-NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberCOA-00271-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: