Healthcare Provider Details

I. General information

NPI: 1922558535
Provider Name (Legal Business Name): OHIO HEALTH O'BLENESS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 HOSPITAL DR
ATHENS OH
45701-2302
US

IV. Provider business mailing address

65 HOSPITAL DR
ATHENS OH
45701-2302
US

V. Phone/Fax

Practice location:
  • Phone: 318-267-8026
  • Fax:
Mailing address:
  • Phone: 318-267-8026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.020006
License Number StateOH

VIII. Authorized Official

Name: MRS. AMBER ELIZABETH GOKKAYA
Title or Position: FAMILY NURSE PRACTITIONER
Credential: C.N.P.
Phone: 740-593-5551