Healthcare Provider Details

I. General information

NPI: 1477246767
Provider Name (Legal Business Name): OKSANA GORDEYEVA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870 E KEMPER RD # 150
CINCINNATI OH
45249-1675
US

IV. Provider business mailing address

3556 LOBELIA DR
BLUE ASH OH
45241-3333
US

V. Phone/Fax

Practice location:
  • Phone: 513-699-9090
  • Fax: 513-258-2053
Mailing address:
  • Phone: 513-544-8092
  • Fax: 513-653-0364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0036039
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0036039
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.0036039
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.441276
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: