Provider Demographics
NPI:1881263564
Name:IRVING, GINA M
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:IRVING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 STATION DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45065-8724
Mailing Address - Country:US
Mailing Address - Phone:513-377-0502
Mailing Address - Fax:513-619-9547
Practice Address - Street 1:5344 STATION DR
Practice Address - Street 2:
Practice Address - City:SOUTH LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45065-8724
Practice Address - Country:US
Practice Address - Phone:513-377-0502
Practice Address - Fax:513-619-9547
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care