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General NPI Number Information
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NPI Number | 1013323997
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Entity Type | Individual
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Provider Name | NANCY GIBBS
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Gender | Female
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 2020 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4604
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Country | US
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Telephone | 941-798-6557
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Fax | 941-567-2775
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Provider Business Mailing Address
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Address Line | 521 MOUNT VERNON DR
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City | VENICE
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State | FL
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Zip | 34293-1117
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Country | US
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Telephone | 941-798-6557
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Fax | 941-567-2775
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT14601
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License Number State | FL
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