Deonte Alonzo Gibbs I, MN-CNL, PMHNP-BC
Registered Nurse, Psych/Mental Health, Adult in Waukesha, WI. Individual provider (NPI-1).
NPI number1790428357
StatusActive
Last updated in NPPESApr 20, 2022
Details
- NPI
- 1790428357
- Entity type
- Individual (NPI-1)
- Name
- Deonte Alonzo Gibbs I
- Credential
- MN-CNL, PMHNP-BC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 20, 2022
- Certification date
- Apr 20, 2022
- Last updated
- Apr 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 239054-30 | WI | Yes |
Other names
- Deonte Alonzo Gibbs (Professional Name)
Practice location
2428 N Grandview Blvd Ste 102Waukesha, WI 53188-6906
Phone 262-875-4521
Mailing address
11221 Synergy Dr Apt 384Wauwatosa, WI 53222-1287
Phone 262-328-7925
Other practice locations
11221 Synergy Dr Apt 384
Wauwatosa, WI 53222-1287
Wauwatosa, WI 53222-1287
Phone 262-328-7925
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