DEVONA J GIBBS


Address: 196 Timber Ridge Trl, Poplar Bluff, MO 63901-1595
Phone: 5736864133

DEVONA J GIBBS (NPI# 1215915889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215915889
Entity Type Individual
Full Name DEVONA J GIBBS
Credential FNP
Practice Address 196 Timber Ridge Trl
Poplar Bluff
MO 63901-1595
Mailing Address 196 Timber Ridge Trl
Room 205
Poplar Bluff
MO 63901-1595
Practice Telephone 5736864133
Practice Fax Number 5737781099
Mailing Telephone 5737782888
Mailing Fax Number 8776103774
Enumeration Date 2006-01-04
Last Update Date 2016-08-25
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LC0200X Nurse Practitioner
Specialization: Critical Care Medicine
064033 MO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MO 428182034 05
TRAVELERS MEDICARE 500000980 01
AR 133802758 05

Office Location

Street Address 196 TIMBER RIDGE TRL
City POPLAR BLUFF
State MO
Zip Code 63901-1595

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Taxonomy Information

Taxonomy Code 363LC0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Critical Care Medicine

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902279110 Gibbs Wound Care LLC Nurse Practitioner 2210 Barron Rd, Room 205, Poplar Bluff, MO 63901-1908 2015-11-10
1437137056 Doris F Hays Nurse Practitioner 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 2006-01-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1053911297 Madeline Jane Distler Nurse Practitioner 4590 Childrens Pl Stop 90-29916, Saint Louis, MO 63110-1020 2020-10-27
1003949587 Kristin C Robertson Nurse Practitioner 805 Gulf St., Lamar, MO 64759-1238 2007-03-13
1437797727 Jonathan C Kyonka Nurse Practitioner 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 2019-12-17
1588194427 Amanda Agee Nurse Practitioner 15740 S Outer 40 Rd, Chesterfield, MO 63017 2017-06-13
1306206677 Mara Wear Nurse Practitioner 4401 Wornall Road, Kansas City, MO 64111 2016-03-01
1609235506 Renae Brines Nurse Practitioner 4401 Wornall Road, Kansas City, MO 64111 2016-02-19
1275991523 Heather Boyd Nurse Practitioner 4401 Wornall Road, Kansas City, MO 64111 2016-02-02
1376916478 Nathan Hagen Nurse Practitioner 4401 Wornall Rd, Kansas City, MO 64111-3220 2015-11-11
1427473859 Michaela Parsel Nurse Practitioner 4401 Wornall Rd, Kansas City, MO 64111-3220 2014-02-21
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Competitor

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City POPLAR BLUFF
Zip Code 63901

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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