Healthcare Provider Details

I. General information

NPI: 1487523007
Provider Name (Legal Business Name): GABRIELLE NADINE BOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 BEECHMONT AVE
CINCINNATI OH
45230-4119
US

IV. Provider business mailing address

76 VIEW TERRACE DR STE 10
SOUTHGATE KY
41071-5420
US

V. Phone/Fax

Practice location:
  • Phone: 859-640-0724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4048085
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: