Healthcare Provider Details

I. General information

NPI: 1780160119
Provider Name (Legal Business Name): GIBBENS FAMILY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 STATE AVE
PANAMA CITY FL
32405-4361
US

IV. Provider business mailing address

2428 JENKS AVE UNIT A
PANAMA CITY FL
32405-4304
US

V. Phone/Fax

Practice location:
  • Phone: 850-640-0663
  • Fax: 850-889-1510
Mailing address:
  • Phone: 850-640-0663
  • Fax: 850-889-1510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY GIBBENS
Title or Position: MANAGER
Credential: ARNP-C
Phone: 850-640-0663