Individual
SHEILA O'SHEA GIBBENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 PASEO DEPERLTA, SANTA FE, NM 87501-2233
(505) 467-1575
(505) 467-1577
Mailing address
PO BOX 1485, PENA BLANCA, NM 87041-1485
(505) 467-1575
(505) 467-1577
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2002-0013
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64985768
—
NM
Enumeration date
07/26/2006
Last updated
07/08/2007
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