Individual
SHANNON DAWN GIBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(539) 240-0171
Mailing address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(539) 240-0171
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0066716
OK
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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