Andria Marie Gibb PA-C

NPI 1720378862 - Physician Assistant - 363A00000X

NPI Details
NPI 1720378862
Gender Female
Enumeration Date 04/11/2011
Last Updated 11/12/2015
Entity Type Individual
Active Over 5 years ago
Practice Location
2055 S FREMONT AVE
SPRINGFIELD MO, 65804-2206, US
Phone (417) 820-2468
Fax (417) 820-7794
Business Location
PO BOX 505164
SAINT LOUIS MO, 63150-5164, US
Phone (417) 829-4620
Fax (660) 826-9888
Toxanomy
Taxonomy Code 363A00000X
License State Missouri
License Number 2011008542
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According to our database, Mrs. Andria Marie Gibb PA-C NPI is 1720378862, taxonomy code is 363A00000X and license number is 2011008542, license state is located at Missouri. Andria Marie Gibb PA-C physically located at 2055 S Fremont Ave, Springfield MO, 65804-2206. NPI Number Andria Marie Gibb PA-C has the Individual type.

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1720378862 NPI number is provided on an as is basis without warranty of any kind. 1720378862 is maintained by the National Plan & Provider Enumeration System. The contents of Andria Marie Gibb PA-C are for informational purposes only.