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NPI Code Detail

MEDICARE: DANIELLE GIBSON

MEDICARE: DANIELLE GIBSON
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1528560406
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE GIBSON
Provider Business Mailing Address
First Line : 5800 LAURENT DR APT 421
Second Line :
City : PARMA
State : OH
Zip : 44129-5969
Country : US
Telephone Number : 216-466-7780
Fax Number :
Provider Business Practice Location Address
First Line : 23701 MILES RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5473
Country : US
Telephone Number : 216-763-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2018
Last Update Date : 03/06/2018

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Directions to “ DANIELLE GIBSON ” Practice Location

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