Provider Demographics
NPI:1033629183
Name:GIBBONS, CLAUDIA J (MHS, PA-C)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:J
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:J
Other - Last Name:GIBBONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 STRATFORD LAKES DR UNIT 227
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-3480
Mailing Address - Country:US
Mailing Address - Phone:860-817-7414
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 10467
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27404-0467
Practice Address - Country:US
Practice Address - Phone:336-207-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07629207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine