Provider Demographics
NPI:1346543550
Name:GIBBONS, JOAN C (RN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:C
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:RN
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 302
Mailing Address - Street 2:180 CENETARY HILL
Mailing Address - City:RINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17967-0302
Mailing Address - Country:US
Mailing Address - Phone:570-205-6179
Mailing Address - Fax:
Practice Address - Street 1:180 CEMETERY HL
Practice Address - Street 2:
Practice Address - City:RINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:17967-9715
Practice Address - Country:US
Practice Address - Phone:570-205-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN229275L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health