Gibson, Jill R

Gibson, Jill R is an individual health care provider with primary practice located at 35 Michigan St Ne Suite 4150, Grand Rapids MI 49503-2514. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Gibson, Jill R can be contacted via phone (616) 267-2100.

Contact Information

Primary practice address
35 Michigan St Ne Suite 4150 Grand Rapids MI 49503-2514
Phone: (616) 267-2100
Fax: (616) 267-2101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 4704165794 Michigan

Profile Details

NPI number 1073553376
LBN Legal business name Gibson, Jill R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Jan 28th, 2013 - about 11 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073553376 NPPES
Michigan MEDICAID 4631797
Michigan Other 500870355

Popular Providers