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:
Health care specialties
| Specialty | Code | License # | 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 13 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 | 1073553376 | NPPES |
| Michigan | MEDICAID | 4631797 | |
| Michigan | Other | 500870355 |
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