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General NPI Number Information
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NPI Number | 1568597094
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Entity Type | Individual
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Provider Name | STEPHANIE GIBSON R.PH., PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 155 EAST BROAD STREET SUITE 1700
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City | COLUMBUS
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State | OH
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Zip | 43215
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Country | US
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Telephone | 614-566-0063
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Fax |
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Provider Business Mailing Address
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Address Line | 1176 GWYNDALE DR
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City | NEW ALBANY
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State | OH
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Zip | 43054-9202
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Country | US
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Telephone |
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 24176
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License Number State | OH
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