=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235649294
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VONYA GIBBONS DNP, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2017
-----------------------------------------------------
Last Update Date | 05/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4076 NEELY ROAD
-----------------------------------------------------
City | FORT WAINWRIGHT
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-361-4000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4076 NEELY ROAD
-----------------------------------------------------
City | FORT WAINWRIGHT
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-361-4000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 62974
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN-2979
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------