Healthcare Provider Details

I. General information

NPI: 1407487028
Provider Name (Legal Business Name): MARLISHA GILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2020
Last Update Date: 11/25/2023
Certification Date: 11/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5922 PIQUA AVE
CINCINNATI OH
45224-3018
US

IV. Provider business mailing address

5922 PIQUA AVE
CINCINNATI OH
45224-3018
US

V. Phone/Fax

Practice location:
  • Phone: 513-439-0309
  • Fax:
Mailing address:
  • Phone: 513-439-0309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number50092816
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRQ672931
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: