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General NPI Number Information
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NPI Number | 1629110697
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Entity Type | Organization
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Legal Business Name | GWENDOLYN GIBSON-HUNT, A PROFESSIONAL NURSING CORP
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 10230 ARTESIA BLVD STE 218
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City | BELLFLOWER
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State | CA
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Zip | 90706-6769
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Country | US
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Telephone | 562-804-5000
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Fax | 562-804-5006
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Provider Business Mailing Address
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Address Line | 10230 ARTESIA BLVD STE 218
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City | BELLFLOWER
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State | CA
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Zip | 90706-6769
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Country | US
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Telephone | 562-804-5000
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Fax | 562-804-5006
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Authorized Official
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Title or Position | PRESIDENT ADMINISTRATOR CEO
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Name | MRS. GWENDOLYN GIBSON-HUNT
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Credential | REGISTERED NURSE
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Telephone | 562-804-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | RN539580
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License Number State | CA
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