NPI 1821166679 · live from the CMS NPI Registry
Penelope M Gibson, PA
Physician Assistant, Medical in Burlington, VT. National Provider Identifier 1821166679, active.
NPI record
| NPI | 1821166679 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 111 Colchester Ave, Fahc Hematology Oncology, East Pavilion Level 2, Burlington, VT 05401 |
| Practice phone | 802-847-8400 |
| Mailing address | 2 Hideaway Ln, Williston, VT 05495 |
| Enumerated | December 1, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 0550030790 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.