Healthcare Provider Details

I. General information

NPI: 1134065899
Provider Name (Legal Business Name): MEGHAN GIBSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

IV. Provider business mailing address

1236 KENTLAND CT
HEBRON KY
41048-9375
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-7289
  • Fax:
Mailing address:
  • Phone: 224-315-0357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4041328
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: