Individual
KELLY K GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
303 GERVAIS RD, FRANKLIN FURNACE, OH 45629-8742
(740) 259-7002
Mailing address
637 JOELL LN, WHEELERSBURG, OH 45694-1964
(740) 464-5263
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
392196
OH
164W00000X
Licensed Practical Nurse
P.N. 142099 M IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392196
OHIO BOARD OF NURSING
OH
Enumeration date
04/26/2011
Last updated
03/30/2017
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