Provider Demographics
NPI:1629110697
Name:GWENDOLYN GIBSON-HUNT, A PROFESSIONAL NURSING CORP
Entity Type:Organization
Organization Name:GWENDOLYN GIBSON-HUNT, A PROFESSIONAL NURSING CORP
Other - Org Name:HUNSONS AMBULATORY INFUSION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT ADMINISTRATOR CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON-HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:562-804-5000
Mailing Address - Street 1:10230 ARTESIA BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6769
Mailing Address - Country:US
Mailing Address - Phone:562-804-5000
Mailing Address - Fax:562-804-5006
Practice Address - Street 1:10230 ARTESIA BLVD STE 218
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6769
Practice Address - Country:US
Practice Address - Phone:562-804-5000
Practice Address - Fax:562-804-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN539580261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy