Provider Demographics
NPI:1205131885
Name:FEBUS, GISSELLE (LND, RD)
Entity type:Individual
Prefix:MS
First Name:GISSELLE
Middle Name:
Last Name:FEBUS
Suffix:
Gender:F
Credentials:LND, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 7152
Mailing Address - Street 2:
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782-9625
Mailing Address - Country:US
Mailing Address - Phone:939-244-0840
Mailing Address - Fax:
Practice Address - Street 1:40 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782-2537
Practice Address - Country:US
Practice Address - Phone:939-244-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR01059444133V00000X
PR1600133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered