Provider Demographics
NPI:1295595916
Name:GIBBS, STACION RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:STACION
Middle Name:RENEE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PORCHER ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-5282
Mailing Address - Country:US
Mailing Address - Phone:302-724-0222
Mailing Address - Fax:
Practice Address - Street 1:740 S NEW ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3571
Practice Address - Country:US
Practice Address - Phone:302-674-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily