Individual
BRENNA A GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1121 BELL WEST BLVD, BELEVILLE, WI 53508
(608) 424-3384
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
74034-20
WI
207Q00000X
Family Medicine Physician
7766-851
WI
208M00000X
Hospitalist Physician
74034-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2019
Last updated
11/10/2022
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