Healthcare Provider Details

I. General information

NPI: 1639105976
Provider Name (Legal Business Name): MARY ESTELLE GETHINS-GARDNER ARNP,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

4919 JESSUP RD
CINCINNATI OH
45247-5908
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-6304
  • Fax:
Mailing address:
  • Phone: 513-385-8318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1082377 REG#2226P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: