MEDICARE: KAREN LEE GIBBS

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1326790460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LEE GIBBS

Provider Business Mailing Address
First Line	:	3512 11TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2025
Country	:	US
Telephone Number	:	202-255-4471
Fax Number	:

Provider Business Practice Location Address
First Line	:	3512 11TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2025
Country	:	US
Telephone Number	:	202-462-0563
Fax Number	:

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

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	01/20/2022

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Directions to “ KAREN LEE GIBBS ” Practice Location

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