Provider Demographics
NPI:1336182005
Name:GECKLE, KIMBERLY E (DNP,AGACNP-BC,SNP-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:GECKLE
Suffix:
Gender:F
Credentials:DNP,AGACNP-BC,SNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1214
Mailing Address - Country:US
Mailing Address - Phone:419-423-5262
Mailing Address - Fax:419-423-5550
Practice Address - Street 1:1900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1214
Practice Address - Country:US
Practice Address - Phone:419-423-5221
Practice Address - Fax:419-423-5143
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA06581-NP363LA2100X, 363LF0000X
OHCOA.06581-NP208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000344352OtherANTHEM BC/BS
OH000000545552OtherANTHEM BC/BS
OH2286806Medicaid
OHP00337392OtherRAILROAD CARE
OH000000344352OtherANTHEM BC/BS
OHNP10604Medicare PIN
OHNP10603Medicare PIN
OHP00337392OtherRAILROAD CARE