Basic Information
| Provider Information | |||||||||
| NPI: | 1295828556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIBBS | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LOWERY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1355 | ||||||||
| Address2: | |||||||||
| City: | BEAR | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197017355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023684311 | ||||||||
| FaxNumber: | 3023691503 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 S COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197022377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023691501 | ||||||||
| FaxNumber: | 3023691503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | LG-0000359 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.