1134452238 NPI number — ABIGAIL L. GAMBY APRN-CNP

Table of content: ABIGAIL L. GAMBY APRN-CNP (NPI 1134452238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134452238 NPI number — ABIGAIL L. GAMBY APRN-CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAMBY
Provider First Name:
ABIGAIL
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN-CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134452238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 ACKERMAN RD STE 2120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43202-1559
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-599-6105
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2220 TIMBER TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEFONTAINE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43311-9039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-599-6105
Provider Business Practice Location Address Fax Number:
937-292-3450
Provider Enumeration Date:
09/08/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  315859 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: APRN.CNP.11074 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: COA.11074-NP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)