Gibbs Wound Care LLC
Nurse Practitioner, Critical Care Medicine in Poplar Bluff, MO. Organization (NPI-2).
NPI number1902279110
StatusActive
Last updated in NPPESNov 10, 2015
Details
- NPI
- 1902279110
- Entity type
- Organization (NPI-2)
- Legal business name
- Gibbs Wound Care LLC
- Organization subpart
- No
- Enumeration date
- Nov 10, 2015
- Last updated
- Nov 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LC0200X | Nurse Practitioner, Critical Care Medicine | 0236239 | MO | Yes |
Practice location
2210 Barron RdRoom 205
Poplar Bluff, MO 63901-1908
Phone 573-686-4133 · Fax 573-778-1099
Mailing address
2210 Barron RdRoom 205
Poplar Bluff, MO 63901-1908
Phone 573-686-4133 · Fax 573-778-1099
Authorized official
Devona D Gibbs
Nurse Practitioner
5736864133
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