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Individual

JENNIFER ANN GIBBONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
440 WOODWARD AVE, IRON MOUNTAIN, MI 49801-4631
(906) 776-9040
(906) 774-5950
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
209008287
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
4704316878
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2010007220
AMERICAN NURSES CREDENTIALING CENTER
Enumeration date
08/11/2010
Last updated
11/22/2019
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