Provider Demographics
NPI:1295828556
Name:GIBBS, JENNIFER LOWERY (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOWERY
Last Name:GIBBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1355
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-7355
Mailing Address - Country:US
Mailing Address - Phone:302-368-4311
Mailing Address - Fax:302-369-1503
Practice Address - Street 1:1901 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2377
Practice Address - Country:US
Practice Address - Phone:302-369-1501
Practice Address - Fax:302-369-1503
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily