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General NPI Number Information
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NPI Number | 1497596340
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Entity Type | Individual
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Provider Name | TAMMY GIBSON
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 956 LAKEWOOD BLVD
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City | AKRON
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State | OH
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Zip | 44314-2959
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Country | US
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Telephone | 330-926-7061
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3081
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City | AKRON
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State | OH
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Zip | 44309-3081
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Country | US
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Telephone | 330-926-7061
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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