NPI 1285930818 · live from the CMS NPI Registry
Shelly Marie Gibbon
Registered Nurse in West Bend, WI. National Provider Identifier 1285930818, active.
NPI record
| NPI | 1285930818 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse 163W00000X |
| Practice location | 6116 Anne Marie Ct, West Bend, WI 53095 |
| Practice phone | 262-629-5190 |
| Enumerated | January 29, 2011 |
| Last updated | February 1, 2011 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Hospice | 163WH1000X | 132870-30 (WI) |
| Registered Nurse primary | 163W00000X | 132870-30 (WI) |
| Registered Nurse, Home Health | 163WH0200X | 132870-30 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.