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Individual

KERRY GIBBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
1371 SEABURY AVE, BRONX, NY 10461
(718) 294-6200
(718) 294-6259
Mailing address
120 HICKSVILLE RD, BETHPAGE, NY 11714-3443
(516) 717-1839

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11472
CT
363LA2200X
Adult Health Nurse Practitioner
251826
GA
363LA2200X
Adult Health Nurse Practitioner
F309445
NY

Other

Enumeration date
09/12/2019
Last updated
06/04/2024
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