Rainey Gibson, Eric Jon
Rainey Gibson, Eric Jon is an individual health care provider with primary practice located at 1003 Grand Avenue , West Des Moines IA 50265-3502. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Rainey Gibson, Eric Jon can be contacted via phone (515) 267-1003.Contact Information
Primary practice address
1003 Grand Avenue
West Des Moines IA 50265-3502
Phone: (515) 267-1003
Fax: (515) 267-0100
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | HSP00445 | Iowa |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 00966 | Iowa |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | HSP00445 | Iowa |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 00966 | Iowa |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | HSP00445 | Iowa |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 00966 | Iowa |
Profile Details
| NPI number | 1528036761 |
|---|---|
| LBN Legal business name | Rainey Gibson, Eric Jon |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1528036761 | NPPES |
| Iowa | Other | 36432 | BLUE SHIELD |
| Iowa | MEDICAID | 1045898 | BLUE SHIELD |
| Iowa | Other | IA0134 | BLUE SHIELD |
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