Shelly Marie Gibbon
Registered Nurse in West Bend, WI. Individual provider (NPI-1).
NPI number1285930818
StatusActive
Last updated in NPPESFeb 1, 2011
Details
- NPI
- 1285930818
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Shelly Marie Gibbon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2011
- Last updated
- Feb 1, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 132870-30 | WI | Yes |
| 163WH1000X | Registered Nurse, Hospice | 132870-30 | WI | |
| 163WH0200X | Registered Nurse, Home Health | 132870-30 | WI |
Practice location
6116 Anne Marie CtWest Bend, WI 53095-9167
Phone 262-629-5190
Mailing address
6116 Anne Marie CtWest Bend, WI 53095-9167
Phone 262-629-5190
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