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General NPI Number Information
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NPI Number | 1225420409
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Entity Type | Individual
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Provider Name | AMANDA KATHERINE GIBSON
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Gender | Female
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 3200 VINE ST
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City | CINCINNATI
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State | OH
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Zip | 45220-2213
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Country | US
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Telephone | 513-861-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 310 OAK ST APT 701
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City | CINCINNATI
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State | OH
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Zip | 45219-2555
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Country | US
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Telephone | 336-460-4712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 06013488
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License Number State | OH
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