MEDICARE: DANIELLE GIBBENS DNP, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	0024190769	VA
2	363LF0000X	Family Nurse Practitioner	0024190769	VA

General Provider Information

NPI Number	:	1144068123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE GIBBENS DNP, FNP-C

Provider Business Mailing Address
First Line	:	8436 REFLECTION LN
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-5212
Country	:	US
Telephone Number	:	952-239-2899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 SPRING HILL RD STE 210
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3039
Country	:	US
Telephone Number	:	703-738-4342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	03/06/2025

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