Individual
MARIANNE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
455 SAINT MICHAELS DR, PHYSICIAN PRACTICES, SANTA FE, NM 87505-7601
(505) 946-4307
Mailing address
455 SAINT MICHAELS DR, PHYSICIAN PRACTICES, SANTA FE, NM 87505-7601
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
346
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10020810
LOVELACE
—
01
—
2340275
UHC
—
05
—
60688777
—
NM
01
—
NM00RF74
BCBS NM
NM
01
—
QMYPR0068979
MOLINA
—
Enumeration date
03/09/2006
Last updated
09/03/2013
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