1700037439 NPI number — MISS MARLENE NICHOLE GIBBS RNBSN

Table of content: MISS MARLENE NICHOLE GIBBS RNBSN (NPI 1700037439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700037439 NPI number — MISS MARLENE NICHOLE GIBBS RNBSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIBBS
Provider First Name:
MARLENE
Provider Middle Name:
NICHOLE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RNBSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700037439
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4D RIDGEWAY SQUARE
Provider Second Line Business Mailing Address:
VALLEY RUN APARTMENTS
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2250 HICKORY RD
Provider Second Line Business Practice Location Address:
240
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-879-4471
Provider Business Practice Location Address Fax Number:
610-684-4767
Provider Enumeration Date:
09/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN593788 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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