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General NPI Number Information
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NPI Number | 1275895625
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Entity Type | Individual
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Provider Name | HEATHER NICOLE GIBBS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 33663 BAYVIEW MEDICAL DRIVE
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City | LEWES
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State | DE
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Zip | 19958
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Country | US
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Telephone | 302-645-9325
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Fax | 302-644-1203
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Provider Business Mailing Address
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Address Line | 33663 BAYVIEW MEDICAL DR.
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City | LEWES
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State | DE
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Zip | 19958
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Country | US
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Telephone | 302-645-9325
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Fax | 302-644-1203
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C1-0012483
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL34717
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License Number State | SC
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