Individual
MRS. YULIA GIBNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP- BC, PMHNP- BC
Contact information
Practice address
100 HIGHLAND AVE STE 204, SALEM, MA 01970-2702
(781) 244-0115
Mailing address
100 HIGHLAND AVE STE 204, SALEM, MA 01970-2702
(781) 244-0115
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2280839
MA
363LW0102X
Women's Health Nurse Practitioner
RN2280839
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104409204
NCC CERTIFICATION
MA
01
—
2023124341
ANCC PMHNP CERTIFICATION
MA
01
—
RN2280839
MASSACHUSETTS NP LICENSE
MA
Enumeration date
10/04/2017
Last updated
12/20/2023
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