Individual
BRENNA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
3220 LAURA LN, WESTLAKE, OH 44145-5471
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.427191
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0029142
OH
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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