Individual
PENELOPE M GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 COLCHESTER AVE, FAHC HEMATOLOGY ONCOLOGY, EAST PAVILION LEVEL 2, BURLINGTON, VT 05401-1473
(802) 847-8400
Mailing address
2 HIDEAWAY LN, WILLISTON, VT 05495-9426
(802) 879-3163
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0550030790
VT
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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