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General NPI Number Information
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NPI Number | 1528153806
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Entity Type | Individual
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Provider Name | DALE R GIBSON APRN
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 715 N KANSAS AVE SUITE 206
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City | HASTINGS
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State | NE
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Zip | 68901-4453
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Country | US
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Telephone | 402-460-5555
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Fax | 402-483-3297
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Provider Business Mailing Address
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Address Line | 1600 S 48TH ST STE 600
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City | LINCOLN
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State | NE
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Zip | 68506-1283
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Country | US
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Telephone | 402-483-3333
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Fax | 402-483-3297
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110258
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License Number State | NE
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