National Provider Identifier

Jaevonna Angelique Gibbs

Jaevonna Angelique Gibbs is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in North Chili, NY and a listed phone number of (585) 414-0964.

NPI 1699244400North Chili, NYLicensed Practical Nurse

Profile Overview

NPI
1699244400
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
November 21, 2018
Last Updated
November 21, 2018

Practice Location

  • 13 Rio Grande Dr
  • North Chili, NY 14514-9761

Phone: (585) 414-0964

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1699244400
Entity Type
Individual
Last Name
Gibbs
First Name
Jaevonna
Middle Name
Angelique
Mailing Street Address
13 Rio Grande Dr
Mailing City
North Chili
Mailing State
NY
Mailing ZIP Code
14514-9761
Mailing Country
US
Practice Street Address
13 Rio Grande Dr
Practice City
North Chili
Practice State
NY
Practice ZIP Code
14514-9761
Practice Country
US
Practice Phone
(585) 414-0964
Enumeration Date
November 21, 2018
Last Updated
November 21, 2018
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)