Gibbs, Devona J
Gibbs, Devona J is an sole proprietor health care provider with primary practice located at 196 Timber Ridge Trl , Poplar Bluff MO 63901-1595. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, which is considered as her primary health care specialty. Gibbs, Devona J can be contacted via phone (573) 686-4133.Contact Information
Primary practice address
196 Timber Ridge Trl
Poplar Bluff MO 63901-1595
Phone: (573) 686-4133
Fax: (573) 778-1099
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine | 363LC0200X | 064033 | Missouri |
Profile Details
| NPI number | 1215915889 |
|---|---|
| LBN Legal business name | Gibbs, Devona J |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Aug 25th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215915889 | NPPES |
| Missouri | MEDICAID | 428182034 | |
| Missouri | MEDICAID | 133802758 | |
| Missouri | Other | 500000980 |
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