Brenna A Gibbons, MD
Family Medicine in Beleville, WI. Individual provider (NPI-1).
NPI number1083176861
StatusActive
Last updated in NPPESNov 10, 2022
Details
- NPI
- 1083176861
- Entity type
- Individual (NPI-1)
- Name
- Brenna A Gibbons
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 2, 2019
- Certification date
- Nov 10, 2022
- Last updated
- Nov 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 74034-20 | WI | Yes |
| 207Q00000X | Family Medicine | 7766-851 | WI | |
| 208M00000X | Hospitalist | 74034-20 | WI | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1121 Bell West BlvdBeleville, WI 53508
Phone 608-424-3384
Mailing address
7974 Uw Health CtMiddleton, WI 53562-5531
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