Healthcare Provider Details
I. General information
NPI: 1821260761
Provider Name (Legal Business Name): AIRIKA SUZAN GIBBS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2008
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 HEWITT BLVD
RED WING MN
55066-2848
US
IV. Provider business mailing address
PO BOX 860912
MINNEAPOLIS MN
55486-0912
US
V. Phone/Fax
- Phone: 651-267-5000
- Fax:
- Phone: 651-267-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | A01374 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | LICC-746 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: