Provider Demographics
NPI:1649513243
Name:GBEHAN, FIONA NATALIE
Entity type:Individual
Prefix:MRS
First Name:FIONA
Middle Name:NATALIE
Last Name:GBEHAN
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 1:1025 PALAMINO LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-2001
Mailing Address - Country:US
Mailing Address - Phone:719-244-4676
Mailing Address - Fax:
Practice Address - Street 1:1025 PALAMINO LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-2001
Practice Address - Country:US
Practice Address - Phone:719-244-4676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1618469163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse