Provider Demographics
NPI:1639663693
Name:GIBBS, CARLA ANDREA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ANDREA
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1661 S MAIN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2728
Mailing Address - Country:US
Mailing Address - Phone:540-564-7300
Mailing Address - Fax:757-431-7100
Practice Address - Street 1:1661 S MAIN ST FL 1
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2728
Practice Address - Country:US
Practice Address - Phone:540-564-7300
Practice Address - Fax:757-431-7100
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101272640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program